ES2333240T3 - ELECTROCHURGICAL GENERATOR AND SYSTEM. - Google Patents
ELECTROCHURGICAL GENERATOR AND SYSTEM. Download PDFInfo
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- ES2333240T3 ES2333240T3 ES05786860T ES05786860T ES2333240T3 ES 2333240 T3 ES2333240 T3 ES 2333240T3 ES 05786860 T ES05786860 T ES 05786860T ES 05786860 T ES05786860 T ES 05786860T ES 2333240 T3 ES2333240 T3 ES 2333240T3
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
- A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
- A61B18/1206—Generators therefor
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
- A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
- A61B18/14—Probes or electrodes therefor
- A61B18/1442—Probes having pivoting end effectors, e.g. forceps
- A61B18/1445—Probes having pivoting end effectors, e.g. forceps at the distal end of a shaft, e.g. forceps or scissors at the end of a rigid rod
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2018/00571—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for achieving a particular surgical effect
- A61B2018/00607—Coagulation and cutting with the same instrument
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2018/00636—Sensing and controlling the application of energy
- A61B2018/00696—Controlled or regulated parameters
- A61B2018/00726—Duty cycle
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
- A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
- A61B18/1206—Generators therefor
- A61B2018/124—Generators therefor switching the output to different electrodes, e.g. sequentially
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Abstract
Description
Generador y sistema electroquirúrgicos.Electrosurgical generator and system.
Esta invención se refiere a un sistema generador electroquirúrgico, y de un sistema electroquirúrgico que comprende un generador y un instrumento electroquirúrgico con dos o más electrodos de tratamiento. Dichos sistemas son utilizados normalmente para el corte y/o la coagulación de tejidos en intervenciones quirúrgicas, sobre todo en cirugía la paroscópica ("keyhole") o cirugía mínimamente invasiva, pero también en cirugía laparoscópica o cirugía "abierta".This invention relates to a generator system electrosurgical, and an electrosurgical system comprising a generator and an electrosurgical instrument with two or more treatment electrodes These systems are used normally for cutting and / or coagulation of tissues in surgical interventions, especially in paroscopic surgery ("keyhole") or minimally invasive surgery, but also in laparoscopic surgery or "open" surgery.
Es conocido el recurso de disponer generadores electroquirúrgicos que proporcionan diferentes señales de radiofrecuencia para corte y coagulación, y también el de disponer una señal mixta en la que el generador alterna rápidamente entre las señales para corte y para coagulación. Nuestra Patente US Nº 6 416 509 y también la Patente US Nº 3 885 569, de Judson, describen señales mixtas de este tipo. El documento U.S. 2003/163124 (Goble) da a conocer un sistema electroquirúrgico que incluye un instrumento electroquirúrgico que tiene como mínimo tres electrodos. En un modo combinado, las formas de onda de corte y coagulación son distribuidas simultáneamente o bien alternando constantemente entre primer y segundo valores umbrales de tensión de salida para formar una señal mixta. El sistema de circuitos hace que la forma de onda de corte sea distribuida entre un primer par de electrodos, y que la forma de onda de coagulación sea distribuida entre un segundo par de electrodos en el modo mixto.The resource of having generators is known electrosurgical that provide different signals from radiofrequency for cutting and coagulation, and also to arrange a mixed signal in which the generator quickly alternates between signals for cutting and coagulation. Our US Patent No. 6 416 509 and also US Patent No. 3,885,559 to Judson, describe mixed signals of this type. The U.S. document 2003/163124 (Goble) discloses an electrosurgical system that includes a Electrosurgical instrument that has at least three electrodes. In a combined mode, the cut and coagulation waveforms are distributed simultaneously or constantly alternating between first and second output voltage threshold values to form a mixed signal The circuit system makes the waveform cutting is distributed between a first pair of electrodes, and that the coagulation waveform is distributed between a second pair of electrodes in mixed mode.
Según la presente invención, un sistema generador electroquirúrgico para generar potencia de radiofrecuencia, comprende:According to the present invention, a system electrosurgical generator to generate power from radio frequency, includes:
- (i) (i)
- una etapa de salida de radiofrecuencia que tiene tres o más conexiones de salida,a radio frequency output stage that has three or more output connections,
- (ii) (ii)
- una o más fuentes de potencia de salida de radiofrecuencia acopladas a la etapa de salida,one or more output power sources of radio frequency coupled to the output stage,
- (iii) (iii)
- un controlador operativo para provocar que el sistema suministre potencia en un modo combinado en el que son distribuidas una primera forma de onda de RF de corte y una segunda forma de onda de RF de coagulación a las conexiones de salida, incluyendo el controlador medios para alimentar las formas de onda a las conexiones de salida de manera que la primera forma de onda de RF es distribuida entre un primer par de conexiones de salida, y la segunda forma de onda de RF es distribuida entre un segundo par de conexiones de salida,an operating driver to cause the system supply power in a combined mode in which they are distributed a first cut-off RF waveform and a second Coagulation RF waveform to the output connections, including the controller means to feed the waveforms to the output connections so that the first waveform of RF is distributed between a first pair of output connections, and the second RF waveform is distributed between a second pair of output connections,
siendo tal la disposición del sistema que el modo combinado es ajustable entre varias configuraciones, teniendo cada configuración una proporción diferente de las primera y segunda formas de onda de RF, y tal que, en respuesta a una señal de entrada activada por operador, el controlador provoca que el sistema suministre una secuencia de forma de onda de salida que comienza en una configuración inicial predeterminada, finaliza en una configuración final predeterminada, y cambia entre las configuraciones inicial y final según una evolución predeterminada.the system arrangement being such that the Combined mode is adjustable between various settings, having each configuration a different proportion of the first and second RF waveforms, and such that, in response to an input signal activated by operator, the controller causes the system supply an output waveform sequence that begins at a default initial configuration, ends in a default final settings, and switch between initial and final settings according to an evolution default
Nuestra solicitud pendiente de patente europea EP 1 287 788 describe un sistema electroquirúrgico en el que el operador puede seleccionar entre una señal de corte y una señal de coagulación. Cuando es seleccionada la señal de corte, esta es suministrada a un par de electrodos electroquirúrgicos, y cuando es seleccionada la señal de coagulación esta es suministrada a un par diferente de electrodos electroquirúrgicos. Nuestra solicitud pendiente de patente de EE.UU. US2003-0163124 es una mejora sobre este sistema, por cuanto que además proporciona un modo combinado de funcionamiento, pero siendo los diferentes componentes de la señal combinada suministrados a diferentes conjuntos de electrodos electroquirúrgicos. La presente invención proporciona otra mejora en la que la secuencia de la forma de onda de salida evoluciona desde una configuración inicial predeterminada hasta una configuración final predeterminada.Our pending European patent application EP 1 287 788 describes an electrosurgical system in which the operator can select between a cut signal and a signal of coagulation. When the cut signal is selected, this is supplied to a pair of electrosurgical electrodes, and when it is selected the coagulation signal is supplied to a pair different from electrosurgical electrodes. Our request US patent pending US2003-0163124 is a improvement over this system, since it also provides a combined mode of operation, but being the different components of the combined signal supplied to different sets of electrosurgical electrodes. The present invention provides another improvement in which the waveform sequence output evolves from a default initial configuration up to a final default configuration.
La evolución de la secuencia de la forma de onda ofrece varias ventajas al usuario. Cuando un instrumento electroquirúrgico está siendo utilizando para cortar tejido, en particular tejido grueso, es difícil coagular completamente el tejido antes de que comience el corte. Si se lleva a cabo una coagulación prolongada antes de que comience el corte, existe el riesgo de que algunas partes del tejido resulten deshidratadas. El tejido deshidratado es poco receptivo a la energía de RF, y por lo tanto no será eficaz una forma de onda de corte aplicada posteriormente. A la inversa, si la coagulación es incompleta, existe el riesgo de que se produzca hemorragia durante el corte. Por lo tanto, los cirujanos tienden a cambiar reiteradamente entre los modos de coagulación y de corte de los generadores electroquirúrgicos, a medida que se forman hemorragias (lo que hace necesario el accionamiento repetido del conmutador de pedal o similar). El generador descrito en la presente solicitud mantiene un elemento de coagulación durante todo el proceso de corte, con una proporción diferente de las formas de onda de corte y de coagulación a medida que avanza el tratamiento del tejido.The evolution of the waveform sequence It offers several advantages to the user. When an instrument electrosurgical is being used to cut tissue, in particular thick tissue, it is difficult to completely clot the tissue before the cut begins. If one is carried out prolonged coagulation before the cut begins, there is risk that some parts of the tissue are dehydrated. He dehydrated tissue is poorly receptive to RF energy, and so both an applied cut-off waveform will not be effective later. Conversely, if coagulation is incomplete, there is a risk of bleeding during the cut. Therefore, surgeons tend to repeatedly switch between the coagulation and cutting modes of the generators electrosurgical, as hemorrhages form (which makes Repeated actuation of the foot switch is necessary or Similary). The generator described in this application maintains a coagulation element during the entire cutting process, with a different proportion of the cut and coagulation waveforms as tissue treatment progresses.
Preferentemente, la primera forma de onda de RF de corte es una forma de onda en la que la tensión de salida de radiofrecuencia desarrollada a través de las conexiones de salida está limitada a por lo menos un primer valor umbral predeterminado para el corte o la vaporización de tejido, y la segunda forma de onda de RF de coagulación es una forma de onda en la que la tensión de salida de radiofrecuencia desarrollada a través de las conexiones de salida está limitada a un segundo valor umbral para coagulación.Preferably, the first RF waveform shear is a waveform in which the output voltage of radio frequency developed through the output connections is limited to at least a first predetermined threshold value for cutting or vaporizing tissue, and the second form of Coagulation RF wave is a waveform in which the voltage Radio frequency output developed through the connections output is limited to a second threshold value for coagulation.
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El "modo combinado" del generador puede disponerse de diferentes maneras. En una configuración, el sistema generador comprende una sola fuente de potencia de radiofrecuencia y, en el modo combinado, el controlador es operativo para hacer que el sistema generador alterne constantemente entre la distribución de la primera forma de onda de RF de corte y la de la segunda forma de onda de RF de coagulación. Esta es la señal "mixta" más tradicional de las patentes US Números 6 416 509 y 3 885 569. Alternativamente, el sistema generador comprende por lo menos una primera y una segunda fuentes de potencia de radiofrecuencia, que funcionan a diferentes frecuencias, estando la primera fuente de potencia de radiofrecuencia adaptada para distribuir la primera forma de onda de RF de corte, y estando la segunda fuente de potencia de radiofrecuencia adaptada para distribuir la segunda forma de onda de RF de coagulación y, en el modo combinado, el controlador es operativo para provocar que el sistema generador suministre simultáneamente las primera y segunda formas de onda de RF. Ésta es una disposición diferente en la cual la salida de las dos fuentes de RF es suministrada al instrumento simultáneamente. Sin embargo, ambas disposiciones tienen el efecto de suministrar las señales de RF tanto de corte como de coagulación al instrumento electroquirúrgico, mientras el instrumento está en uso.The "combined mode" of the generator can be arranged in different ways. In a configuration, the system generator comprises a single source of radio frequency power and, in combined mode, the controller is operational to make the generator system alternates constantly between the distribution of the first cut-off RF waveform and the second form of Coagulation RF wave. This is the "mixed" signal more Traditional US Patent Nos. 6 416 509 and 3 885 569. Alternatively, the generator system comprises at least one first and second sources of radio frequency power, which they work at different frequencies, being the first source of radio frequency power adapted to distribute the first RF waveform cut, and being the second source of radio frequency power adapted to distribute the second Coagulation RF waveform and, in combined mode, the controller is operational to cause the generator system simultaneously supply the first and second waveforms of RF This is a different provision in which the output of Two RF sources are supplied to the instrument simultaneously. However, both provisions have the effect of providing RF signals from both cutting and coagulation to the instrument electrosurgical, while the instrument is in use.
En una disposición preferente, las diversas configuraciones tienen un primer ciclo de trabajo predeterminado de la primera forma de onda de RF, y un segundo ciclo de trabajo predeterminado de la segunda forma de onda de RF. Preferentemente, la configuración inicial predeterminada tiene una combinación de formas de onda tal que la proporción de la segunda forma de onda de RF es mayor que la proporción de la primera forma de onda de RF. Adicionalmente, la configuración final predeterminada tiene una combinación de formas de onda tal que la proporción de la primera forma de onda de RF es mayor que la proporción de la segunda forma de onda de RF. Ventajosamente, la configuración inicial es una forma de onda que tiene un segundo ciclo de trabajo que está entre el 70% y 100% de la forma de onda total, típicamente entre el 90% y 100% de la salida total suministrada. Alternativa o adicionalmente, la configuración final es una forma de onda que tiene un primer ciclo de trabajo que está entre el 70% y el 100% de la forma de onda total, típicamente entre el 90% y el 100% de la salida total suministrada. En una disposición típica, la configuración inicial es una forma de onda combinada que tiene un primer ciclo de trabajo que es el 100% de la salida total suministrada, y la configuración final es una forma de onda mixta que tiene un segundo ciclo de trabajo que es el 90% de la salida total suministrada.In a preferred arrangement, the various configurations have a first default duty cycle of the first RF waveform, and a second duty cycle Default of the second RF waveform. Preferably the initial default configuration has a combination of waveforms such that the proportion of the second waveform of RF is greater than the proportion of the first RF waveform. Additionally, the default final configuration has a combination of waveforms such that the proportion of the first RF waveform is greater than the proportion of the second form RF wave Advantageously, the initial configuration is a way wave that has a second duty cycle that is between 70% and 100% of the total waveform, typically between 90% and 100% of The total output supplied. Alternatively or additionally, the final configuration is a waveform that has a first cycle of work that is between 70% and 100% of the waveform total, typically between 90% and 100% of total output supplied In a typical arrangement, the initial configuration is a combined waveform that has a first duty cycle that It is 100% of the total output supplied, and the final configuration it is a mixed waveform that has a second duty cycle that It is 90% of the total output supplied.
En la disposición descrita anteriormente, no solo el generador mantiene un elemento de coagulación durante de todo el proceso de corte, sino que la proporción de la forma de onda de coagulación es mayor hacia el inicio del proceso. De este modo, si el cirujano encuentra hemorragia durante el corte electroquirúrgico, el cirujano libera y a continuación reactiva el conmutador de pedal u otro mecanismo de accionamiento. Esto reinicializa la evolución a la configuración inicial, con un grado de coagulación en esta proporcionalmente alto.In the arrangement described above, no only the generator maintains a coagulation element during The whole cutting process, but the proportion of the waveform Coagulation is greater towards the beginning of the process. In this way, if the surgeon finds bleeding during the cut electrosurgical, the surgeon releases and then reactivates the footswitch or other drive mechanism. This reinitializes the evolution to the initial configuration, with a degree of coagulation in this proportionally high.
Preferentemente, la evolución predeterminada desde la configuración inicial a la configuración final es una evolución uniforme durante un tiempo predeterminado. Esto asegura que el corte electroquirúrgico del tejido se producirá tan pronto como sea factible realizarlo. Alternativamente, la evolución puede no ser una evolución uniforme; sino que, por ejemplo, puede tener un periodo inicial en una configuración constante (por ejemplo, una forma de onda predominantemente de coagulación), seguido por una evolución tras este periodo inicial hasta la configuración final (por ejemplo, una forma de onda predominantemente de corte). Independientemente de si la evolución es uniforme, el tiempo adoptado por el generador para evolucionar desde su configuración inicial hasta su configuración final puede ser modificado, dependiendo del tipo de instrumento conectado al generador, o del tipo del tejido en tratamiento.Preferably, the predetermined evolution from initial configuration to final configuration is a uniform evolution for a predetermined time. This ensures that the electrosurgical tissue cut will occur as soon as feasible to do it. Alternatively, evolution can not be a uniform evolution; but, for example, you can have a initial period in a constant configuration (for example, a predominantly coagulation waveform), followed by a evolution after this initial period until the final configuration (for example, a predominantly shear waveform). Regardless of whether evolution is uniform, time adopted by the generator to evolve from its configuration initial until its final configuration can be modified, depending on the type of instrument connected to the generator, or the type of tissue being treated.
Preferentemente, el controlador está adaptado para suministrar una secuencia total de forma de onda de salida, en la forma de una serie de impulsos, convenientemente a una frecuencia de entre 0,5 y 50 Hz, y típicamente a una frecuencia de entre 15 y 25 Hz.Preferably, the controller is adapted to supply a total sequence of output waveform, in the shape of a series of impulses, conveniently at a frequency between 0.5 and 50 Hz, and typically at a frequency between 15 and 25 Hz
A continuación se describe un sistema electroquirúrgico que incluye un aparato generador electroquirúrgico para generar potencia de radiofrecuencia, y un instrumento electroquirúrgico que incluye por lo menos tres electrodos, comprendiendo el aparato generadorA system is described below. electrosurgical which includes an electrosurgical generating apparatus to generate radio frequency power, and an instrument electrosurgical that includes at least three electrodes, comprising the generating apparatus
- (i) (i)
- una etapa de salida de radiofrecuencia que tiene por lo menos dos conexiones en comunicación eléctrica con los electrodos del instrumento,a radio frequency output stage that has for at least two connections in electrical communication with the electrodes of the instrument,
- (ii) (ii)
- una fuente de alimentación acoplada a la etapa de salida para suministrar potencia a la etapa de salida,a power supply coupled to the stage of output to supply power to the output stage,
- (iii) (iii)
- un controlador operativo para provocar que el aparato generador suministre una forma de onda de salida mixta que alterne constantemente entre una primera forma de onda de salida a través de las conexiones de salida en las que la tensión de salida de radiofrecuencia desarrollada a través de las conexiones de salida está limitada a por lo menos un primer valor umbral predeterminado para el corte o la vaporización de tejido, y una segunda forma de onda de salida a través de las conexiones de salidaan operating driver to cause the generator set provide a mixed output waveform that constantly alternate between a first output waveform at through the output connections where the output voltage of radiofrequency developed through the output connections is limited to at least a first predetermined threshold value for cutting or vaporizing tissue, and a second form of output wave through the output connections
en el que la tensión de salida de radiofrecuencia desarrollada a través de las conexiones de salida está limitada a un segundo valor umbral para la coagulación, incluyendo el controlador medios para alimentar las formas de onda a las conexiones de salida de manera que la primera forma de onda de salida es suministrada entre un primer par de las conexiones de salida, y la segunda forma de onda de salida es suministrada entre un segundo par de las conexiones de salida, siendo el controlador capaz de provocar que el aparato generador distribuya la forma de onda en diversas configuraciones, teniendo cada una de las diversas configuraciones un primer ciclo de trabajo predeterminado de la forma de onda que está limitado al primer valor umbral para el corte o la vaporización, y un segundo ciclo de trabajo predeterminado de la forma de onda que está limitado al segundo valor umbral para la coagulación, siendo la disposición del sistema tal que, en respuesta a una señal de entrada activada por un operador, el controlador provoca que el aparato generador suministre una secuencia de la forma de onda de salida que comienza en una configuración inicial predeterminada, finalizando en una configuración final predeterminada, y cambiando entre las configuraciones inicial y final según una evolución predeterminada. Por lo menos dos de los electrodos tienen la forma de un par de mandíbulas.in which the output voltage of radio frequency developed through the output connections is limited to a second threshold value for coagulation, including the controller means to feed the waveforms to the output connections so that the first waveform of output is supplied between a first pair of the connections of output, and the second output waveform is supplied between a second pair of the output connections, the controller being capable of causing the generating apparatus to distribute the form of wave in different configurations, having each of the different configurations a first predetermined duty cycle of the waveform that is limited to the first threshold value for cutting or vaporization, and a second predetermined duty cycle of the waveform that is limited to the second threshold value for the coagulation, the system arrangement being such that, in response to an input signal activated by an operator, the controller causes the generating apparatus to provide a sequence of the output waveform that begins in an initial configuration default, ending in a final configuration default, and switching between the initial settings and final according to a predetermined evolution. At least two of the Electrodes are shaped like a pair of jaws.
Por consiguiente, la invención se extiende a un sistema electroquirúrgico que comprendeAccordingly, the invention extends to a electrosurgical system comprising
- (i) (i)
- un instrumento electroquirúrgico bipolar que incluye una empuñadura, un conjunto de mandíbulas dispuestas de manera que la manipulación de la empuñadura permite que las mandíbulas opuestas del conjunto de mandíbulas se abran y se cierren una con respecto a otra; teniendo la primera de las mencionadas mandíbulas opuestas por lo menos un primer electrodo de coagulación; teniendo la otra de las mencionadas mandíbulas opuestas por lo menos un segundo electrodo de coagulación; y un electrodo de corte, estando el electrodo de corte separado del segundo electrodo de coagulación por medio de un elemento aislante, ya bipolar electrosurgical instrument that includes a handle, a set of jaws arranged so that handle manipulation allows opposite jaws of the set of jaws open and close one with respect to other; having the first of the mentioned jaws opposed by at least a first coagulation electrode; having the other one of the mentioned opposite jaws at least a second electrode of coagulation; and a cutting electrode, the cutting electrode being separated from the second coagulation electrode by means of a insulating element, and
- (iii) (iii)
- un aparato generador electroquirúrgico que comprende una o más fuentes de potencia de salida de RF, un controlador operativo para controlar el aparato generador de manera que pueda proporcionar una primera forma de onda de RF de corte al instrumento electroquirúrgico o una segunda forma de onda de RF de coagulación al instrumento electroquirúrgico y, en un modo combinado, proporcionar ambas primera y segunda formas de onda de RF, siendo alimentadas las formas de onda al instrumento electroquirúrgico de manera que, en el modo combinado, la forma de onda de RF de corte es suministrada entre el electrodo de corte y por lo menos uno de los primero y segundo electrodos de coagulación, y la forma de onda de RF de coagulación es suministrada entre el primer y segundo electrodos de coagulación, siendo ajustable el modo combinado entre diversas configuraciones, teniendo cada configuración una proporción diferente de las primera y segunda formas de onda de RF, siendo la disposición del aparato generador tal que, en respuesta a una señal de entrada accionada por operador, el controlador provoca que el aparato generador suministre una secuencia de forma de onda de salida que comienza en una configuración inicial predeterminada, finalizando en una configuración final predeterminada, y cambiando entre las configuraciones inicial y final de acuerdo con una evolución predeterminada.an electrosurgical generating apparatus comprising one or more RF output power sources, a controller operational to control the generator set so that it can provide a first cut-off RF waveform to the instrument electrosurgical or a second coagulation RF waveform to the electrosurgical instrument and, in a combined mode, provide both first and second RF waveforms, being fed the waveforms to the electrosurgical instrument of so that, in the combined mode, the cut-off RF waveform is supplied between the cutting electrode and at least one of the first and second coagulation electrodes, and the waveform of Coagulation RF is supplied between the first and second coagulation electrodes, the combined mode being adjustable between different configurations, each configuration having a proportion different from the first and second RF waveforms, being the arrangement of the generating apparatus such that, in response to a signal operator-driven input, the controller causes the generator set supply a waveform sequence of output that begins in a default initial configuration, ending in a default final configuration, and changing between the initial and final settings according to a default evolution.
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El funcionamiento del sistema preferente para modificar tejido comprende las etapas de:The operation of the preferred system for modify tissue comprises the steps of:
- (i) (i)
- poner en contacto el tejido con un instrumento electroquirúrgico, que incluye por lo menos primero y segundo electrodosput the tissue in contact with an instrument electrosurgical, which includes at least first and second electrodes
- (ii) (ii)
- suministrar a los primero y segundo electrodos una combinación de formas de onda electroquirúrgicas que incluye una primera proporción que comprende una forma de onda de RF de corte y una segunda proporción que comprende una forma de onda de RF de coagulación, ysupply the first and second electrodes a combination of electrosurgical waveforms that includes a first proportion comprising a cut-off RF waveform and a second proportion comprising an RF waveform of coagulation, and
- (iii) (iii)
- variar las proporciones de las primera y segunda formas de onda, según una evolución predeterminada.vary the proportions of the first and second waveforms, according to a predetermined evolution.
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La invención se describirá en mayor detalle a continuación, solo a modo de ejemplo, con referencia a los dibujos anexos. En los dibujos:The invention will be described in greater detail at then, by way of example only, with reference to the drawings annexes In the drawings:
la figura 1 es una representación esquemática de un sistema electroquirúrgico, según la presente invención,Figure 1 is a schematic representation of an electrosurgical system, according to the present invention,
la figura 2 es un diagrama de bloques del generador de la figura 1,Figure 2 is a block diagram of the generator of figure 1,
la figura 3 es una vista esquemática en perspectiva de un instrumento electroquirúrgico utilizado como parte del sistema de la figura 1,Figure 3 is a schematic view in perspective of an electrosurgical instrument used as part of the system of figure 1,
la figura 4 es un esquema de un circuito de conmutación utilizado en el sistema de la figura 1,Figure 4 is a schematic of a circuit of switching used in the system of figure 1,
las figuras 5A y 5B son esquemas de circuitos de dos dispositivos electrónicos de conmutación para el circuito de conmutación de la figura 4,Figures 5A and 5B are circuit diagrams of two electronic switching devices for the circuit switching of figure 4,
la figura 6 es un esquema de una realización alternativa del circuito de conmutación que puede ser utilizado en el sistema de la figura 1,Figure 6 is a schematic of one embodiment. switching circuit alternative that can be used in the system of figure 1,
la figura 7 es un diagrama de bloques de un generador, según la figura 2, que incorpora un circuito de conmutación según la figura 4,Figure 7 is a block diagram of a generator, according to figure 2, which incorporates a circuit of switching according to figure 4,
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las figuras 8A hasta 8C son esquemas que muestran técnicas para ajustar una relación de conmutación mixta, siendo las figuras 8A hasta 8C esquemas de circuito de dispositivos alternativos de ajuste de la relación y siendo la figura 8B un diagrama de forma de onda que muestra el funcionamiento del dispositivo de la figura 8A,Figures 8A through 8C are schemes that show techniques for adjusting a mixed switching ratio, Figures 8A to 8C being circuit diagrams of devices alternatives for adjusting the ratio and figure 8B being a waveform diagram showing the operation of the device of figure 8A,
la figura 9 es un diagrama de bloques de una realización alternativa del sistema generador, según la presente invención,Figure 9 is a block diagram of a alternative embodiment of the generator system, according to the present invention,
la figura 10 es un diagrama de bloques de otro sistema alternativo, según la invención,Figure 10 is a block diagram of another alternative system, according to the invention,
las figuras 11A y 11B son otros sistemas alternativos para alimentar salidas de corte y de coagulación automáticamente a diferentes pares de electrodos respectivos,Figures 11A and 11B are other systems Alternatives to feed cutting and coagulation outputs automatically to different pairs of respective electrodes,
las figuras 12 y 13 son diagramas de bloques de otros sistemas alternativos, según la invención,Figures 12 and 13 are block diagrams of other alternative systems, according to the invention,
las figuras 14A y 14B son diagramas de formas de onda que muestran diferentes formas de onda mixtas que pueden ser producidas por un generador según la invención,Figures 14A and 14B are diagrams of shapes of wave that show different mixed waveforms that can be produced by a generator according to the invention,
la figura 15 es una vista esquemática de un conmutador de pedal utilizado como parte de un sistema electroquirúrgico, según la presente invención,Figure 15 is a schematic view of a footswitch used as part of a system electrosurgical, according to the present invention,
las figuras 16 y 17 son diagramas que muestran el ajuste del generador, según la invención,Figures 16 and 17 are diagrams showing the generator setting according to the invention,
la figura 18 es una vista en sección esquemática de un instrumento electroquirúrgico alternativo utilizado como parte del sistema de la figura 1,Figure 18 is a schematic sectional view. of an alternative electrosurgical instrument used as part of the system of figure 1,
la figura 19 es una vista en perspectiva de un conjunto de mandíbulas del instrumento de la figura 18,Figure 19 is a perspective view of a jaw assembly of the instrument of figure 18,
la figura 20 es una vista en sección transversal del cuerpo del instrumento la figura 18,Figure 20 is a cross-sectional view. of the body of the instrument figure 18,
la figura 21 es una vista desde un extremo, del conjunto de mandíbulas de la figura 19, yFigure 21 is a view from one end of the set of jaws of figure 19, and
la figura 22 es una vista lateral del conjunto de mandíbulas de la figura 19.Figure 22 is a side view of the assembly of jaws of figure 19.
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En referencia a la figura 1, un generador (10) tiene un enchufe hembra (10S) de salida que proporciona una salida de radiofrecuencia (RF) para un instrumento (12) mediante de un cable de conexión (14). La activación del generador puede llevarse a cabo desde el instrumento (12) mediante de una conexión en el cable (14) o por medio de una unidad de pedal de conmutación (16), tal como se muestra, conectada a la parte trasera del generador mediante un cable (18) de conexión del pedal de conmutación. En la realización muestrada, la unidad (16) del pedal de conmutación tiene dos pedales (16A) y (16B) para seleccionar un modo de coagulación y un modo de corte del generador, respectivamente. El panel frontal del generador tiene pulsadores (20) y (22) para configurar respectivamente los niveles de potencia de coagulación y de corte, que son indicados en una pantalla (24). Los pulsadores (26) están dispuestos como medio alternativo para la selección entre los modos de coagulación y de corte.Referring to figure 1, a generator (10) It has a female socket (10S) output that provides an output of radio frequency (RF) for an instrument (12) by means of a connection cable (14). Generator activation can lead to out from the instrument (12) through a cable connection (14) or by means of a switching pedal unit (16), such as shown, connected to the rear of the generator by a connection cable (18) of the switching pedal. In the embodiment shown, the unit (16) of the switching pedal has two pedals (16A) and (16B) to select a coagulation mode and a generator cut mode, respectively. Front panel The generator has buttons (20) and (22) to configure respectively coagulation and cutting power levels, which are indicated on a screen (24). The buttons (26) are arranged as an alternative means for selection between modes of coagulation and cutting.
En referencia a la figura 2, el generador comprende un oscilador de potencia (60) de radiofrecuencia (RF) que tiene un par de líneas de salida (60C) para acoplar al instrumento (12). El instrumento (12) se muestra en la figura 2 en la forma de una carga eléctrica (64). Se suministra potencia al oscilador (60) mediante una fuente de alimentación (66) en modo conmutado. En la realización preferente, el oscilador de RF (60) funciona a unos 400 kHz, siendo viable cualquier frecuencia de 300 kHz y superior, en el rango de HF. La fuente de alimentación en modo conmutado funciona típicamente a una frecuencia en el rango de 25 a 50 kHz. A través de la línea de salida (60C) está acoplado un detector (68) de umbral de tensión, que tiene una primera salida (68A) acoplada a la fuente de alimentación (16) en modo conmutado y una segunda salida (68B) acoplada a un circuito (70) de control del tiempo "activado". Un controlador (72) del microprocesador acoplado a los controles y a la pantalla del operador (mostrados en la figura 1) está conectado a una entrada de control (66A) de la fuente de alimentación (66) para ajustar la potencia de salida del generador por medio de suministrar variación de tensión, y a una entrada (68C) de ajuste del umbral del detector (68) del umbral de tensión, para configurar los límites de la tensión máxima de salida de RF.Referring to figure 2, the generator comprises a radio frequency (RF) power oscillator (60) that It has a pair of output lines (60C) to attach to the instrument (12). The instrument (12) is shown in Figure 2 in the form of an electric charge (64). Power is supplied to the oscillator (60) via a power supply (66) in switched mode. In the preferred embodiment, the RF oscillator (60) operates at about 400 kHz, any frequency of 300 kHz and higher being viable, in the HF range. Switching mode power supply works typically at a frequency in the range of 25 to 50 kHz. Through the output line (60C) is coupled a threshold detector (68) of voltage, which has a first output (68A) coupled to the source of power supply (16) in switched mode and a second output (68B) coupled to a "activated" time control circuit (70). A microprocessor controller (72) coupled to the controls and to the operator screen (shown in figure 1) is connected to a control input (66A) of the power supply (66) for adjust the generator output power by supplying voltage variation, and to a threshold adjustment input (68C) of the voltage threshold detector (68), to set the limits of the maximum RF output voltage.
En funcionamiento, el controlador (72) del microprocesador provoca que se aplique potencia a la fuente de alimentación (66) en modo conmutado cuando se demanda potencia electroquirúrgica por el cirujano activando un dispositivo de conmutación de activación que puede estar dispuesta en una empuñadura o en un pedal de conmutación (véase la figura 1). Un umbral de tensión de salida constante es ajustado independientemente en la tensión de alimentación a través de la entrada (68C), de acuerdo con las configuraciones de control en el panel frontal del generador (véase la figura 1). Típicamente, para deshidratación o coagulación el umbral se fija en un valor umbral de deshidratación entre 150 voltios y 200 voltios. Cuando se necesita una salida de corte o vaporización, entonces el umbral se fija a un valor en el rango entre 250 ó 300 voltios y 600 voltios. Estos valores de tensión son valores máximos. Que sean valores máximos significa que para la deshidratación por lo menos es preferible tener una forma de onda de RF de salida de factor de cresta bajo para proporcionar la potencia máxima antes de que la tensión se restrinja a los valores proporcionados. Típicamente se consigue un factor de cresta de 1,5 o menos. Cuando se necesita una salida en modo combinado, la tensión de salida ajustada a través de la entrada (68C) se alterna constantemente entre el valor para deshidratación o coagulación y el valor para corte o vaporización, para crear una forma de onda mixta.In operation, the controller (72) of the microprocessor causes power to be applied to the source of power (66) in switched mode when power is demanded electrosurgical by the surgeon activating a device activation switching that may be arranged in a handle or on a switching pedal (see figure 1). A constant output voltage threshold is set independently in the supply voltage through the input (68C), of according to the control settings on the front panel of the generator (see figure 1). Typically, for dehydration or coagulation the threshold is set to a dehydration threshold value between 150 volts and 200 volts. When you need an exit from cut or vaporization, then the threshold is set to a value in the range between 250 or 300 volts and 600 volts. These values of Tension are maximum values. That they are maximum values means that for dehydration at least it is preferable to have a form of RF wave output from low crest factor to provide the maximum power before the voltage is restricted to values provided. Typically a peak factor of 1.5 or less. When a combined mode output is needed, the voltage Output adjusted through input (68C) alternates constantly between the value for dehydration or coagulation and the value for cutting or vaporization, to create a waveform mixed.
Cuando el generador es activado primero, el estado de la entrada de control (601) del oscilador (60) de RF (que está conectado al circuito (70) de control del tiempo "activado") es "activado", de manera que el dispositivo de conmutación de potencia que forma el elemento oscilante del oscilador (60) es conectado durante un periodo de conducción máximo en cada ciclo de oscilación. La potencia entregada a la carga (64) depende en parte de la tensión de alimentación aplicada al oscilador RF (60) desde la fuente de alimentación (66) en modo conmutado, y en parte de la impedancia de carga (64). La tensión umbral para una salida de deshidratación se configura para provocar el envío de señales de activación al circuito (70) de control del tiempo "activado" y a la fuente de alimentación (66) en modo conmutado cuando se alcanza el umbral de tensión. El circuito (70) de control del tiempo "activado" tiene el efecto de reducir de manera prácticamente instantánea el tiempo "activado" del dispositivo de conmutación del oscilador RF. Simultáneamente, la fuente de alimentación en modo conmutado es desactivada, de manera que la tensión suministrada al oscilador (60) empieza a caer. El funcionamiento del generador de este modo se describe en detalle en nuestra Solicitud de Patente Europea Número 075443.When the generator is activated first, the status of the control input (601) of the RF oscillator (60) (which is connected to the time control circuit (70) "activated") is "activated", so that the device power switching that forms the oscillating element of the Oscillator (60) is connected during a maximum driving period in each swing cycle. The power delivered to the load (64) depends in part on the supply voltage applied to the oscillator RF (60) from the power supply (66) in switched mode, and in part of the load impedance (64). The threshold voltage for a dehydration output is configured to cause the sending of activation signals to the time control circuit (70) "activated" and to the power supply (66) in switched mode when the voltage threshold is reached. The control circuit (70) of the "activated" time has the effect of reducing virtually "device" activated time RF oscillator switching. Simultaneously, the source of switching mode power is disabled, so that the voltage supplied to the oscillator (60) begins to fall. He generator operation in this way is described in detail in Our European Patent Application Number 075443.
La figura 3 muestra un posible diseño para el instrumento electroquirúrgico (12). El instrumento (12) comprende un eje (5) del instrumento en el extremo del cual se encuentra un conjunto de electrodo mostrado en general como (8). El conjunto de electrodo (8) comprende un electrodo de corte central (2) dispuesto entre dos electrodos de coagulación (3) y (40) mayores. La capa de aislamiento (4) separa el electrodo de corte (2) del primer electrodo de coagulación (3), mientras que una capa de aislamiento (41) separa el electrodo de corte (2) del segundo electrodo de coagulación (40). El electrodo de corte (2) sobresale ligeramente sobre los dos electrodos de coagulación.Figure 3 shows a possible design for the electrosurgical instrument (12). The instrument (12) comprises an axis (5) of the instrument at the end of which is a electrode assembly generally shown as (8). The set of electrode (8) comprises a central cutting electrode (2) arranged between two coagulation electrodes (3) and (40) larger. The layer of insulation (4) separates the cutting electrode (2) from the first coagulation electrode (3) while an insulating layer (41) separates the cutting electrode (2) from the second electrode of coagulation (40). The cutting electrode (2) protrudes slightly on the two coagulation electrodes.
Cuando el usuario intenta que el instrumento corte tejido, el generador aplica una forma de onda de RF entre el electrodo de corte (2) y uno o ambos electrodos de coagulación (3) y (40). A la inversa, cuando el usuario intenta que el instrumento coagule tejido, el generador aplica una forma de onda RF de coagulación entre los dos electrodos de coagulación (3) y (40). La aplicación de la forma de onda de RF mixta se describirá con referencia al circuito de conmutación mostrado en la figura 4.When the user tries to make the instrument woven cut, the generator applies an RF waveform between the cutting electrode (2) and one or both coagulation electrodes (3) and (40). Conversely, when the user tries to make the instrument coagulate tissue, the generator applies an RF waveform of coagulation between the two coagulation electrodes (3) and (40). The Application of the mixed RF waveform will be described with reference to the switching circuit shown in figure 4.
La figura 4 muestra un circuito de conmutación indicado en general en (45) y que comprende conexiones de entrada (46) y (47) conectadas respectivamente a las dos líneas de salida (60C) del generador (10). El circuito de conmutación (45) tiene tres conexiones de salida (48), (49) y (50). La conexión de salida (48) está conectada al electrodo de corte (2) en el dispositivo de la figura 3. Las conexiones de salida (49) y (50) están respectivamente conectadas a los electrodos de coagulación (3) y (40) en el dispositivo de la figura 3. Un dispositivo electrónico de conmutación (51) está conectado entre las conexiones de salida (48) y (49). El conmutador (51) puede hacer e interrumpir rápidamente la conexión entre las líneas de salida (48) y (49). Un condensador (53) está conectado entre las conexiones de salida (49) y (50), teniendo típicamente el condensador un valor de entre 1 y 10 nF.Figure 4 shows a switching circuit generally indicated in (45) and comprising input connections (46) and (47) connected respectively to the two output lines (60C) of the generator (10). The switching circuit (45) has three output connections (48), (49) and (50). The output connection (48) is connected to the cutting electrode (2) in the device of the Figure 3. The output connections (49) and (50) are respectively connected to the coagulation electrodes (3) and (40) in the device of figure 3. An electronic device of switching (51) is connected between the output connections (48) and (49). The switch (51) can quickly make and interrupt the connection between the output lines (48) and (49). A condenser (53) is connected between the output connections (49) and (50), the capacitor typically having a value between 1 and 10 nF.
Cuando el usuario activa los pedales (16A) o (16B) para hacer funcionar el instrumento (12) en el modo mixto, el generador suministra ráfagas alternativas de formas de onda de RF de corte y de coagulación a las conexiones de entrada (46) y (47). El dispositivo de conmutación (51) funciona sincronizado con las formas de onda de RF alternas de manera que cuando se recibe la parte de la forma de onda que contiene la forma de onda de corte, el dispositivo de conmutación se abre de manera que hay un circuito abierto entre las conexiones de salida (48) y (49). De este modo la forma de onda de RF de corte es suministrada entre el electrodo de corte (2) y el electrodo de coagulación (40), a través de conexiones de salida (48) y (50) respectivamente. A la inversa, cuando la parte de la forma de onda que contiene la tensión de coagulación se recibe a través de las conexiones de entrada (46) y (47), el dispositivo de conmutación (51) es cerrado de modo que las conexiones de salida (48) y (49) están en comunicación eléctrica entre sí. De este modo, durante la parte de coagulación de la forma de onda mixta, la forma de onda es suministrada entre dos electrodos de coagulación (3) y (40), a través de las conexiones de salida (49) y (50), proporcionando el condensador (53) una diferencia de potencial entre ambas.When the user activates the pedals (16A) or (16B) to operate the instrument (12) in mixed mode, the generator supplies alternative bursts of RF waveforms from cutting and coagulation to the input connections (46) and (47). He switching device (51) works synchronized with the shapes alternating RF waveform so that when you receive the part of the waveform that contains the cut waveform, the device switching opens so that there is an open circuit between the output connections (48) and (49). In this way the waveform RF cutting is supplied between the cutting electrode (2) and the coagulation electrode (40), through output connections (48) and (50) respectively. Conversely, when the part of the form wave that contains the coagulation voltage is received through the input connections (46) and (47), the switching device (51) is closed so that the output connections (48) and (49) They are in electrical communication with each other. Thus, during the coagulation part of the mixed waveform, the waveform is supplied between two coagulation electrodes (3) and (40), to through the output connections (49) and (50), providing the capacitor (53) a potential difference between the two.
El dispositivo de conmutación (51) puede comprender un relé óptico de CA tal como la disposición de FET dual acoplado ópticamente, mostrada en la figura 5A. Otro dispositivo de conmutación que proporciona aislamiento entre los circuitos de control y la línea de salida es la combinación de un puente de corriente alterna y un solo conmutador MOSFET controlado a través de un controlador de aislamiento, tal como se muestra en la figura 5B.The switching device (51) can comprise an AC optical relay such as the dual FET arrangement optically coupled, shown in Figure 5A. Other device of switching that provides isolation between the circuits of control and the starting line is the combination of a bridge of alternating current and a single MOSFET switch controlled through an isolation controller, as shown in the figure 5B.
La descripción anterior está basada en el generador (10) controlando la forma de onda en modo mixto, y el dispositivo de conmutación (51) abriéndose y cerrándose de manera sincronizada con este. Sin embargo, este no tiene por qué ser el caso y el dispositivo de conmutación puede controlar el generador para determinar el cambio entre las formas de onda de RF de corte y de coagulación.The above description is based on the generator (10) controlling the mixed mode waveform, and the switching device (51) opening and closing so synchronized with this. However, this does not have to be the case and the switching device can control the generator to determine the change between the cut-off RF waveforms and of coagulation
Se tomará en consideración el circuito de conmutación (45) que se muestra en la figura 4. Cuando el dispositivo de conmutación (51) está en su situación abierta, la forma de onda de corte es suministrada a través de las conexiones de salida (48) y (50). Cuando el dispositivo de conmutación (51) se cierra, la forma de onda de corte es suministrada inicialmente entre las conexiones de salida (49) y (50), separadas por el condensador (53). Esto provoca que la corriente suministrada por el generador aumente rápidamente de manera que el conjunto de circuitos de limitación de la corriente dentro del generador funcione para reducir la potencia que está siendo suministrada, de modo que la forma de onda se convierte rápidamente en una típica forma de onda de RF para coagulación. El efecto del sistema de circuitos de limitación de corriente dentro del generador es que el cierre del dispositivo de conmutación (51) provoca que la forma de onda que está siendo suministrada se transforme casi instantáneamente, pasando de una forma de onda de corte a una forma de onda de coagulación. A la inversa, cuando el dispositivo de conmutación (51) vuelve a abrirse, el generador deja de estar limitado en corriente, y una vez más la forma de onda vuelve rápidamente a ser una forma de onda de RF de corte. De este modo, la apertura y el cierre del dispositivo de conmutación (51) alternan el generador entre sus modos de corte y de coagulación, produciendo la forma de onda mixta que es suministrada a los electrodos del instrumento (12).The circuit of switching (45) shown in figure 4. When the switching device (51) is in its open situation, the Cut-off waveform is supplied through the connections of output (48) and (50). When the switching device (51) is close, the cut-off waveform is initially supplied between the output connections (49) and (50), separated by the capacitor (53). This causes the current supplied by the generator increase rapidly so that the circuitry of current limitation within the generator work for reduce the power being supplied, so that the waveform quickly becomes a typical waveform of RF for coagulation. The effect of the circuit system of current limitation within the generator is that the closing of the switching device (51) causes the waveform to It is being supplied almost instantly, moving from a cut waveform to a waveform of coagulation. Conversely, when the switching device (51) reopens, the generator is no longer limited in current, and once again the waveform quickly becomes a form of RF wave cut. In this way, the opening and closing of the switching device (51) alternates the generator between their cutting and coagulation modes, producing the mixed waveform which is supplied to the electrodes of the instrument (12).
La figura 6 muestra una realización alternativa
del circuito de conmutación, que puede ser utilizada si el generador
(10) no es un generador limitado en corriente, o si se desea no
utilizar las características de limitación de corriente del
generador. El circuito de conmutación de la figura 6 es casi
idéntico al de la figura 4, siendo la principal diferencia la
adición de un condensador (52) adicional en serie con la conexión de
entrada (46). El condensador (52) tiene típicamente un valor que es
la mitad del valor del condensador (53), de manera que la tensión
suministrada a través de las conexiones de salida (49) y (50) es
reducida a un nivel utilizado típicamente para la coagulación sin
reducir la salida de potencia del generador (10). De este modo, se
suministra una forma de onda de RF de corte entre las conexiones de
salida (48) y (50) cuando el dispositivo de conmutación (51) está
abierto, y se suministra una forma de onda
de RF de
coagulación entre las conexiones de salida (49) y (50) cuando el
dispositivo de conmutación está cerrado.Figure 6 shows an alternative embodiment of the switching circuit, which can be used if the generator (10) is not a current limited generator, or if it is desired not to use the current limiting characteristics of the generator. The switching circuit of Figure 6 is almost identical to that of Figure 4, the main difference being the addition of an additional capacitor (52) in series with the input connection (46). The capacitor (52) typically has a value that is half the value of the capacitor (53), so that the voltage supplied through the output connections (49) and (50) is reduced to a level typically used for coagulation without reducing the power output of the generator (10). In this way, a cut-off RF waveform is supplied between the output connections (48) and (50) when the switching device (51) is open, and a waveform is supplied
Coagulation RF between the output connections (49) and (50) when the switching device is closed.
El dispositivo de conmutación (45) puede disponerse dentro del instrumento electroquirúrgico (12), o dentro de la etapa de salida del generador (10) tal como se muestra en la figura 7. En cualquier lugar en que esté localizado el circuito de conmutación (45), este puede estar dotado de un dispositivo de ajuste (55), (como el mostrado en la figura 6) manejable por el usuario del sistema para ajustar la temporización del dispositivo de conmutación. Haciendo funcionar el dispositivo de ajuste (55), el usuario puede alterar la relación entre la parte de la forma de onda de RF mixta que es una forma de onda de corte, y la parte que es una forma de onda de coagulación. Esté el dispositivo de ajuste (55) localizado en el instrumento (12) o en el generador (10), el usuario del sistema puede variar la forma de onda para incrementar o reducir la componente de coagulación de la forma de onda mixta con respecto a la componente de corte, y viceversa. Esto proporciona una flexibilidad considerable al sistema electroquirúrgico en términos de su utilización como dispositivo simultáneo de corte y coagulación, con un control manejable por el usuario sobre cuánta coagulación se proporciona.The switching device (45) can be disposed within the electrosurgical instrument (12), or inside of the generator output stage (10) as shown in the Figure 7. Wherever the circuit is located switching (45), this may be provided with a device adjustment (55), (as shown in figure 6) manageable by the system user to adjust the device timing of commutation. By operating the adjustment device (55), the user can alter the relationship between the part of the waveform of mixed RF which is a cut-off waveform, and the part that is a coagulation waveform. Be the adjusting device (55) located in the instrument (12) or in the generator (10), the user of the system can vary the waveform to increase or decrease the coagulation component of the mixed waveform with respect to the cutting component, and vice versa. This provides a considerable flexibility to the electrosurgical system in terms of its use as a simultaneous cutting device and coagulation, with user-manageable control over how much coagulation is provided.
Tal como en la disposición descrita anteriormente en la figura 4, el dispositivo (51) de conmutación del circuito alternativo de conmutación de la figura 6 puede ser tal como se muestra en la figura 5A o en la figura 5B, obteniéndose la señal de excitación desde una fuente asociada con el propio dispositivo de conmutación o desde un sistema de circuitos de control dentro del generador, que controla otras funciones del generador.As in the described arrangement previously in figure 4, the switching device (51) of the Alternative switching circuit of Figure 6 can be such as shown in figure 5A or figure 5B, obtaining the excitation signal from a source associated with the own switching device or from a circuit system of control inside the generator, which controls other functions of the generator.
Para los expertos en la materia serán evidentes varios circuitos para implementar el dispositivo de ajuste (55). En la figura 8A se muestra un ejemplo de un circuito en el que es generada una forma de onda en modo mixto por medio de elementos asociados con el dispositivo de conmutación y tiene una relación variable de trabajo-reposo. En este caso, la salida de un generador (56) de onda triangular es comparada en un comparador (57) con una tensión de referencia ajustable por el usuario para producir una onda cuadrada del dispositivo (51) de conmutación (figura 6). En la figura 8C se muestra otro circuito que genera una señal de control del dispositivo de conmutación en modo mixto, ajustable. En este caso, un potenciómetro (58) activable por el usuario está acoplado con un circuito temporizador (59) utilizando un i.c. ("circuito integrado") 555.For those skilled in the art they will be obvious several circuits to implement the adjustment device (55). In Figure 8A shows an example of a circuit in which it is generated a mixed mode waveform by means of elements associated with the switching device and has a relationship work-rest variable. In this case, the output of a triangular wave generator (56) is compared in a comparator (57) with a reference voltage adjustable by the user to produce a square wave of the device (51) of switching (figure 6). Figure 8C shows another circuit that generates a control signal of the switching device in mode mixed, adjustable. In this case, a potentiometer (58) can be activated by the user is coupled with a timer circuit (59) using an i.c. ("integrated circuit") 555.
La figura 9 muestra un sistema generador alternativo en el que son utilizados dos circuitos fuente de RF (74) y (74'). El circuito fuente (74) comprende el oscilador de RF (60) y sus elementos asociados de fuente de alimentación y control. El circuito fuente es tal como se describe en relación con la figura 2, y los elementos iguales reciben los mismos números de referencia que en la figura 2. El segundo circuito fuente (74') comprende un segundo oscilador de RF (60'), junto con un segundo controlador (72'), una fuente de alimentación (66'), un detector (68') de umbral de tensión y un circuito (70') de control de tiempo. La figura 9 muestra el circuito fuente (74') con su propia versión dedicada de cada una de estas unidades, si bien es factible que parte de estas (tal como la fuente de alimentación -66'- y el controlador -72'-) puedan compartirse con el circuito fuente (74). El detector (68) de umbral de tensión está configurado de manera que las conexiones de salida (60C) procedentes del circuito fuente (74) proporcionen una forma de onda de potencia de salida que tiene una forma de onda de RF de corte, mientras que el detector (68') del umbral de tensión está configurado de manera que las conexiones de salida (60C') procedentes de circuito fuente (74') proporcionen una forma de onda de potencia de salida que tiene una forma de onda de RF de coagulación. El segundo oscilador (60') funciona a una frecuencia diferente a la del oscilador (60).Figure 9 shows a generator system alternative in which two RF source circuits are used (74) and (74 '). The source circuit (74) comprises the RF oscillator (60) and its associated power supply and control elements. He source circuit is as described in relation to figure 2, and the same elements receive the same reference numbers as in figure 2. The second source circuit (74 ') comprises a second RF oscillator (60 '), together with a second controller (72 '), a power supply (66'), a threshold detector (68 ') voltage and a time control circuit (70 '). Figure 9 shows the source circuit (74 ') with its own dedicated version of each of these units, although it is feasible that part of these (such as the power supply -66'- and the controller -72'-) can be shared with the source circuit (74). The detector (68) of voltage threshold is configured so that the connections of output (60C) from the source circuit (74) provide a output power waveform that has a waveform of RF cut-off, while the voltage threshold detector (68 ') is configured so that the output connections (60C ') from source circuit (74 ') provide a waveform of output power that has an RF waveform of coagulation. The second oscillator (60 ') operates at a frequency different from the oscillator (60).
Se dispone una etapa de salida común (73) para ambos circuitos fuente (74) y (74'). Las conexiones de salida (60C) procedentes del circuito fuente (74) están conectadas a conexiones de entrada (46) y (47) de la etapa de salida (73), mientras que las conexiones de salida (60C') procedentes de circuito fuente (74') están conectadas a conexiones de entrada (46') y (47') de la etapa de salida, respectivamente. Dentro de la etapa de salida (73), las conexiones de entrada (47) y (47') están ambas conectadas a la conexión de salida (49), mientras que la conexión de entrada (46) está conectada a la conexión de salida (48), y la conexión de entrada (46') a la conexión de salida (50). El resultado de esta disposición es que la forma de onda de RF de corte procedente del circuito fuente (74) es suministrada entre conexiones de salida (48) y (49) y por lo tanto a un par de electrodos del instrumento electroquirúrgico (12). Simultáneamente, la forma de onda de RF de coagulación procedente del circuito fuente (74') es suministrada entre conexiones de salida (49) y (50) y por lo tanto a un par diferente de electrodos del instrumento (12). De este modo, el instrumento electroquirúrgico (12) puede cortar y coagular tejido simultáneamente en virtud de dos formas de onda de frecuencia diferentes. Igual que anteriormente, la ventaja es que la forma de onda de corte y la forma de onda de coagulación, ya sean aplicadas simultáneamente o en una forma de onda mixta alterna, son suministradas a pares diferentes de electrodos del instrumento electroquirúrgico. Por lo tanto, el diseño de estos electrodos puede ser optimizado, según estén previstos para cortar o para coagular tejido.A common output stage (73) is provided for both source circuits (74) and (74 '). The output connections (60C) from the source circuit (74) are connected to connections input (46) and (47) of the output stage (73), while the output connections (60C ') from source circuit (74') are connected to input connections (46 ') and (47') of the stage output, respectively. Within the exit stage (73), the input connections (47) and (47 ') are both connected to the output connection (49), while the input connection (46) is connected to the output connection (48), and the connection of input (46 ') to the output connection (50). The result of this provision is that the cut-off RF waveform coming from the source circuit (74) is supplied between output connections (48) and (49) and therefore to a pair of electrodes of the instrument electrosurgical (12). Simultaneously, the RF waveform of coagulation from the source circuit (74 ') is supplied between output connections (49) and (50) and therefore a couple different from electrodes of the instrument (12). In this way, the Electrosurgical instrument (12) can cut and coagulate tissue simultaneously under two frequency waveforms different. As before, the advantage is that the form of cutoff waveform and coagulation waveform, whether applied simultaneously or in an alternating mixed waveform, they are supplied to different pairs of instrument electrodes electrosurgical Therefore, the design of these electrodes can be optimized, as planned to cut or coagulate tissue.
En referencia a la figura 10, en otra combinación alternativa de generador e instrumento, dos osciladores de potencia de RF (60-1) y (60-2) son excitados desde una fuente de alimentación común (62) y controlados por un controlador común (72) para producir sobre las respectivas líneas de salida (60C) una forma de onda de potencia de RF adecuada para el corte y una forma de onda de potencia de RF adecuada para la coagulación. Estas formas de onda pueden ser alimentadas a un circuito (63) de conmutación para seleccionar la señal de potencia procedente del oscilador (60-1) o del otro oscilador (60-2), en función de las entradas procedentes de, por ejemplo, conmutadores de pedal, siendo la forma de onda de potencia seleccionada transmitida sobre conexiones de salida (80), (81). En un modo mixto, el conmutador es activado repetidamente a una velocidad predeterminada para producir una forma de onda de potencia de salida mixta a través de las conexiones (80), (81). Los osciladores de potencia (60-1), (60-2) son activados a frecuencias diferentes, y las formas de onda respectivas de corte y de coagulación son alimentadas a los electrodos requeridos alimentando la forma de onda de potencia sobre conexiones de salida (80), (81) a circuitos sintonizados (82-1) y (82-2), sintonizados a frecuencias diferentes. Las salidas de los circuitos sintonizados son acopladas, a través de líneas (48), (49) y (50) de electrodo, a electrodos respectivos del instrumento electroquirúrgico. De este modo, la forma de onda de corte procedente del oscilador (60-1) es alimentada al electrodo de corte (48) y al electrodo común (49), mientras que la forma de onda de coagulación procedente del oscilador (60-2) es alimentada a un electrodo de coagulación (50) y al electrodo común (49).Referring to figure 10, in another alternative combination of generator and instrument, two oscillators RF power (60-1) and (60-2) they are excited from a common power supply (62) and controlled by a common controller (72) to produce on the respective output lines (60C) a power waveform of RF suitable for cutting and an RF power waveform suitable for coagulation. These waveforms can be fed to a switching circuit (63) to select the power signal from the oscillator (60-1) or of the other oscillator (60-2), depending on the inputs from, for example, foot switches, being the selected power waveform transmitted over output connections (80), (81). In a mixed mode, the switch is repeatedly activated at a predetermined speed to produce a mixed output power waveform across the connections (80), (81). Power oscillators (60-1), (60-2) are activated at different frequencies, and the respective cut-off waveforms and of coagulation are fed to the required electrodes feeding the power waveform over output connections (80), (81) to tuned circuits (82-1) and (82-2), tuned to different frequencies. The outputs of the tuned circuits are coupled, through lines (48), (49) and (50) of electrode, to respective electrodes of the electrosurgical instrument Thus, the waveform of cut from the oscillator (60-1) is fed to the cutting electrode (48) and to the common electrode (49), while the coagulation waveform from the oscillator (60-2) is fed to a coagulation electrode (50) and to the common electrode (49).
En la realización muestrada en la figura 10, la conexión entre el generador electroquirúrgico y el instrumento electroquirúrgico está dispuesta típicamente por medio de las conexiones de salida (80) y (81), pero la distribución de los bloques de circuito entre el generador y el instrumento se puede variar.In the embodiment shown in Figure 10, the connection between the electrosurgical generator and the instrument electrosurgical is typically arranged by means of output connections (80) and (81), but the distribution of circuit blocks between the generator and the instrument can be to vary.
En las figuras 11A y 11B se muestran otras realizaciones. Igual que en la realización de la figura 9, estas realizaciones prescinden de la necesidad de un conmutador o un circuito de conmutación de enrutado de la señal.Other figures are shown in Figures 11A and 11B realizations As in the embodiment of Figure 9, you are embodiments ignore the need for a switch or a signal routing switching circuit.
En referencia a la figura 11, se disponen dos circuitos sintonizados (82-1) y (82-2) (tal como en la figura 10), sintonizados a frecuencias diferentes. Cada uno tiene un par inductor-condensador (84) resonante en serie y un par inductor-condensador (86) resonante en paralelo, estando el último acoplado por transformador a conexiones de salida (46) y (47) por una parte y (46') y (47') por otra parte. Igual que en la realización de la figura 10, cada circuito sintonizado tiene dos entradas, una de las cuales está conectada a una conexión (80) de salida del generador y la otra de las cuales está conectada a una conexión (81) de salida del generador. En esta realización, el generador tiene una etapa de salida que comprende conmutadores de RF dispuestos en dos pares en contrafase (90A), (90B) y (91A), (91B) que actúan de manera opuesta. Típicamente, estos conmutadores comprenden MOSFETs de potencia. Cada conmutador (90A), (90B), (91A), (91B) está conectado a entradas (92), (93) de controlador, tal como se muestra, que reciben una señal de excitación de RF que, para producir sobre las conexiones de salida (80), (81) una salida que tenga una forma de onda de corte tiene una cierta frecuencia de RF, y para producir una salida de coagulación en las conexiones (80), (81) de salida, tiene una frecuencia de RF diferente, siendo estas frecuencias, respectivamente, la frecuencia resonante de las combinaciones resonantes (84), (86) del primer circuito sintonizado (82-1), y la frecuencia resonante de las correspondientes combinaciones resonantes del otro circuito sintonizado (82-2). Tal como se ha descrito anteriormente, los conmutadores de RF (90A), (90B), (91A) y (91B) de la etapa de salida del generador pueden ser controlados de acuerdo con, por ejemplo, un control de conmutador de pedal para producir una salida de corte o una salida de coagulación. De nuevo, adicionalmente, se puede producir una salida mixta en la que la frecuencia de RF alterna constantemente entre las dos frecuencias resonantes de los circuitos sintonizados de salida.Referring to figure 11, two are arranged tuned circuits (82-1) and (82-2) (as in Figure 10), tuned to different frequencies Everyone has a pair inductor-capacitor (84) resonant in series and a inductor-capacitor pair (86) resonant in parallel, the last being coupled by transformer to output connections (46) and (47) on the one hand and (46 ') and (47') on the other hand. Like In the embodiment of Figure 10, each tuned circuit has two inputs, one of which is connected to a connection (80) generator output and the other one of which is connected to a connection (81) of generator output. In this embodiment, the generator has an output stage comprising RF switches arranged in two pairs in counter phase (90A), (90B) and (91A), (91B) that act in the opposite way. Typically, these switches They comprise power MOSFETs. Each switch (90A), (90B), (91A), (91B) is connected to controller inputs (92), (93), such as it is shown, that they receive an RF excitation signal that, for produce on the output connections (80), (81) an output that have a cut-off waveform has a certain RF frequency, and to produce a coagulation outlet at the connections (80), (81) output, has a different RF frequency, these being frequencies, respectively, the resonant frequency of the resonant combinations (84), (86) of the first tuned circuit (82-1), and the resonant frequency of corresponding resonant combinations of the other circuit tuned (82-2). As described previously, the RF switches (90A), (90B), (91A) and (91B) of The generator output stage can be controlled according with, for example, a pedal switch control to produce a cutting outlet or a coagulation outlet. Again, additionally, a mixed output can be produced in which the RF frequency constantly alternates between the two frequencies Resonant tuned output circuits.
La realización de la figura 11B es una modificación de la realización de la figura 11A, en la que la etapa de salida del generador tiene un solo par de conmutadores de RF (90A), (90B) en contrafase y en la que cada uno de los circuitos sintonizados tiene una entrada conectada a la conexión entre los conmutadores (90A), (90B) y la otra entrada conectada a tierra.The embodiment of Figure 11B is a modification of the embodiment of figure 11A, in which the stage Generator output has a single pair of RF switches (90A), (90B) in contraphase and in which each of the circuits tuned has an input connected to the connection between the switches (90A), (90B) and the other input connected to ground.
En la figura 12 se muestra otra realización del circuito generador, en la que las salidas de corte y de coagulación están conectadas en serie a través del sistema de circuitos de conmutación. Las conexiones de entrada (131) y (132) están conectadas a la salida del generador, y las conexiones de salida (133) y (134) a los electrodos de coagulación del instrumento electroquirúrgico (12). La conexión de salida (135) está conectada al electrodo de corte del instrumento electroquirúrgico (12).Another embodiment of the generator circuit, in which the cutting and coagulation outputs are connected in series through the circuit system of commutation. The input connections (131) and (132) are connected to the generator output, and the output connections (133) and (134) to the instrument coagulation electrodes electrosurgical (12). The output connection (135) is connected to the cutting electrode of the electrosurgical instrument (12).
Entre las conexiones de entrada (131) y (132) hay un circuito en puente que comprende un primer transformador (136) y un segundo transformador (137). El primer transformador (136) comprende un bobinado primario (138) y un bobinado secundario (139). Un primer elemento de conmutación (140) está dispuesto en paralelo con el bobinado primario (138). El segundo transformador (137) comprende un bobinado primario (141) y un bobinado secundario (142). Un segundo elemento de conmutación (143) está dispuesto en paralelo con el bobinado primario (141). Los elementos de conmutación (140) y (143) son controlados por la unidad de control (144). Los bobinados secundarios (139) y (142) están conectados en serie a través de las conexiones de entrada (131) y (132), constituyendo la conexión entre los dos bobinados (139), (142) una salida en puente.Between the input connections (131) and (132) there is a bridge circuit comprising a first transformer (136) and a second transformer (137). The first transformer (136) comprises a primary winding (138) and a secondary winding (139). A first switching element (140) is arranged in parallel with the primary winding (138). The second transformer (137) comprises a primary winding (141) and a secondary winding (142). A second switching element (143) is arranged in parallel with the primary winding (141). The elements of switching (140) and (143) are controlled by the control unit (144). The secondary windings (139) and (142) are connected in series through the input connections (131) and (132), constituting the connection between the two windings (139), (142) a bridge departure.
El segundo transformador (137) es un transformador reductor en el que el propio bobinado secundario (142) es el primario para otro bobinado secundario (145), con toma central, conectado a través de las conexiones de salida (133) y (134). Un condensador (146) de aislamiento está dispuesto entre el circuito en puente y la conexión (135) de salida de corte, y otros condensadores (147) y (148) de aislamiento lo están entre el circuito en puente y las conexiones (133) y (134) de salida de coagulación.The second transformer (137) is a reducing transformer in which the secondary winding itself (142) It is the primary for another secondary winding (145), with socket central, connected through the output connections (133) and (134). An isolation capacitor (146) is disposed between the bridge circuit and connection (135) cut-off output, and others insulation capacitors (147) and (148) are between the bridge circuit and connections (133) and (134) output of coagulation.
El funcionamiento del circuito es el siguiente. Durante un periodo predeterminado, la unidad de control (144) activa el elemento conmutador (143) para cerrar y cortocircuitar el bobinado primario (141) del segundo transformador (137). En esta situación, con el transformador secundario (141) efectivamente cortocircuitado, la salida del generador es dirigida entre la conexión de salida (135) y ambas conexiones de salida (133) y (134). Esto tiene el efecto de excitar el electrodo de corte del instrumento electroquirúrgico (12) con una tensión de salida de RF con respecto a los electrodos de coagulación del mismo, que efectivamente actúan como electrodos de retorno para la operación de corte electroquirúrgico.The operation of the circuit is as follows. During a predetermined period, the control unit (144) activates the switching element (143) to close and short-circuit the primary winding (141) of the second transformer (137). In this situation, with the secondary transformer (141) effectively shorted, the generator output is directed between the output connection (135) and both output connections (133) and (134). This has the effect of exciting the cutting electrode of the electrosurgical instrument (12) with an RF output voltage with respect to the coagulation electrodes thereof, which effectively act as return electrodes for the operation of electrosurgical cutting
A la finalización del periodo predeterminado, la unidad de control (144) funciona para abrir el conmutador (143) y a continuación cerrar el conmutador (140) para cortocircuitar el bobinado primario (138) del primer transformador (136). Hay un retardo corto predeterminado entre la apertura del conmutador (143) y el cierre del conmutador (140) para asegurar que ambos conmutadores nunca están cerrados al mismo tiempo (puesto que esto cortocircuitaría las conexiones de salida del generador). Con el conmutador (140) cerrado, el primer transformador (136) está efectivamente cortocircuitado, y la salida del generador está dirigida por completo al segundo transformador (137). El segundo transformador es un transformador reductor, y proporciona una señal de tensión menor entre las conexiones de salida (133) y (134). Esto tiene el efecto de excitar los primero y segundo electrodos de coagulación del instrumento electroquirúrgico (12) para producir de este modo una tensión de RF de coagulación entre los mismos.At the end of the predetermined period, the control unit (144) works to open the switch (143) and to then close the switch (140) to short-circuit the primary winding (138) of the first transformer (136). There's a default short delay between switch opening (143) and closing the switch (140) to ensure that both switches are never closed at the same time (since this short circuit generator output connections). With the switch (140) closed, the first transformer (136) is effectively shorted, and the generator output is directed completely to the second transformer (137). The second transformer is a reducing transformer, and provides a signal of lower voltage between the output connections (133) and (134). This it has the effect of exciting the first and second electrodes of coagulation of the electrosurgical instrument (12) to produce this way a coagulation RF voltage between them.
Tras un tiempo predeterminado, la unidad de control (144) abre el conmutador (140) y a continuación cierra el conmutador (143), invirtiendo la situación descrita inicialmente en la que es suministrada una tensión de corte al electrodo de corte del instrumento electroquirúrgico (12). Alternando constantemente entre las dos condiciones descritas en el presente documento, el circuito proporciona una señal de formas de onda de corte y coagulación ("coag") alternantes rápidamente, a un instrumento electroquirúrgico conectado al mismo. De este modo, el instrumento puede cortar tejido tal como se ha descrito previamente, mientras que simultáneamente coagula el tejido para reducir la hemorragia.After a predetermined time, the unit of control (144) opens the switch (140) and then closes the switch (143), reversing the situation initially described in which is supplied a cutting voltage to the cutting electrode of the electrosurgical instrument (12). Alternating constantly between the two conditions described in this document, the circuit provides a signal of cut waveforms and coagulation ("coag") alternating quickly, to an instrument electrosurgical connected to it. In this way, the instrument you can cut tissue as previously described, while which simultaneously coagulates the tissue to reduce the hemorrhage.
La figura 13 muestra una realización alternativa, en la que elementos iguales son designados por los mismos números de referencia. Mientras que la disposición de la figura 12 es especialmente apropiada para un circuito de conmutación en una unidad separada del generador, la disposición de la figura 13 es más apropiada para un sistema de circuitos de conmutación que es integral con el generador. En lugar de que los bobinados secundarios (139) y (142) estén conectados a través del generador tal como en la figura 12, en la disposición de la figura 13 los elementos de conmutación (140) y (143) a través de los bobinados primarios (138) y (141) están conectados por si mismos directamente en serie a través de un generador (150). En la figura 13, el segundo transformador (137) está muestrado como un simple bobinado primario (141) y bobinado secundario (145), sin el aislamiento adicional proporcionado por el transformador de dos etapas mostrado en la figura 12. El funcionamiento del circuito de la figura 13 es sustancialmente como el descrito con referencia a la figura 12, provocando la unidad de control (144) que los conmutadores (140) y (143) se abran y se cierren de forma recíproca. Cuando el conmutador (140) está cerrado, acortando el bobinado primario (138), se suministra una señal de coagulación entre las conexiones de salida (133) y (134). Alternativamente, cuando el conmutador (143) está cerrado, acortando el bobinado primario (141), es suministrada una señal de corte entre la conexión de salida (135) y las conexiones (133) y (134).Figure 13 shows an embodiment alternative, in which equal elements are designated by the Same reference numbers. While the layout of the Figure 12 is especially appropriate for a circuit switching in a separate unit of the generator, the arrangement of Figure 13 is more appropriate for a circuit system of switching that is integral with the generator. Instead of those secondary windings (139) and (142) are connected through the generator as in figure 12, in the arrangement of figure 13 the switching elements (140) and (143) through the primary windings (138) and (141) are connected by themselves directly in series through a generator (150). In the figure 13, the second transformer (137) is shown as a simple primary winding (141) and secondary winding (145), without the additional insulation provided by the two transformer stages shown in figure 12. The operation of the circuit Figure 13 is substantially as described with reference to the Figure 12, causing the control unit (144) that the Switches (140) and (143) open and close reciprocally. When the switch (140) is closed, shortening the winding primary (138), a coagulation signal is supplied between output connections (133) and (134). Alternatively, when the Switch (143) is closed, shortening the primary winding (141), a cut signal is supplied between the output connection (135) and connections (133) and (134).
La figura 14A muestra una primera secuencia de forma de onda de salida mixta que comprende una combinación alternante constantemente de una forma de onda (30) de corte y una forma de onda (31) de coagulación. La forma de onda de corte (30) está limitada a un primer umbral (32) de tensión, mientras que la forma de onda de coagulación (31) está limitada a un segundo (menor) umbral (33) de tensión. La forma de onda de corte (30) es suministrada durante el 50% del ciclo de trabajo, y la forma de onda de coagulación (31) es suministrada durante el restante 50% del ciclo de trabajo. Esta secuencia de forma de onda de salida produce un efecto tejido que corta y coagula simultáneamente tejido.Figure 14A shows a first sequence of mixed output waveform comprising a combination constantly alternating a cut-off waveform (30) and a coagulation waveform (31). The cut waveform (30) is limited to a first voltage threshold (32), while the coagulation waveform (31) is limited to one second (minor) Voltage threshold (33). The cut waveform (30) is supplied during 50% of the work cycle, and the form of coagulation wave (31) is supplied for the remaining 50% of the work cycle. This output waveform sequence produces a tissue effect that cuts and coagulates simultaneously tissue.
La figura 14B muestra una secuencia alternativa de forma de onda de salida mixta, que de nuevo alterna constantemente entre una forma de onda (30) de corte y una forma de onda (31) de coagulación, cada una limitada a umbrales (32) y (33) de tensión respectivamente. Sin embargo, en la secuencia de forma de onda de salida de la figura 14B, la forma de onda (30) de corte es suministrada durante el 90% del ciclo de trabajo, y la forma de onda (31) de coagulación es suministrada durante solo el 10% del ciclo de trabajo. Esta secuencia de forma de onda de salida corta tejido más eficazmente que la forma de onda de la figura 14A, pero tiene menos efecto coagulante sobre el tejido en tratamiento.Figure 14B shows an alternative sequence mixed output waveform, which again alternates constantly between a cut-off waveform (30) and a form of coagulation wave (31), each limited to thresholds (32) and (33) of tension respectively. However, in the form sequence of output wave of figure 14B, the cut waveform (30) is supplied during 90% of the duty cycle, and the waveform (31) coagulation is supplied for only 10% of the cycle of job. This output waveform sequence cuts more tissue effectively than the waveform of figure 14A, but it has less coagulant effect on the tissue being treated.
Las formas de onda mixtas de las figuras 14A y 14B son dos configuraciones predeterminadas para la secuencia de forma de onda de salida mixta de un sistema generador según la presente invención, y pueden ser seleccionadas o ajustadas mediante la utilización de un conmutador de pedal tal como se muestra en la figura 15, siendo dicho conmutador de pedal totalmente convencional. El conmutador de pedal (16) tiene dos pedales (16A) y (16B), siendo el pedal (16A) conocido normalmente como el pedal de corte (y siendo típicamente de color amarillo), y siendo el pedal (16B) conocido normalmente como el pedal de coagulación (y siendo típicamente de color azul). Se dispone un tercer pedal (16C) como un pedal de selección de modo (siendo este pedal típicamente de forma y tamaño diferentes a los otros dos pedales, y normalmente de color negro). El funcionamiento del sistema generador se describirá ahora con referencia a estos pedales, y al diagrama de la figura 16.The mixed waveforms of Figures 14A and 14B are two default settings for the sequence of mixed output waveform of a generator system according to the present invention, and can be selected or adjusted by the use of a foot switch as shown in the Figure 15, said pedal switch being totally conventional. The foot switch (16) has two pedals (16A) and (16B), being the pedal (16A) normally known as the cutting pedal (and being typically yellow), and the pedal (16B) being known normally as the coagulation pedal (and being typically of color blue). A third pedal (16C) is arranged as a pedal mode selection (this pedal being typically of shape and size different from the other two pedals, and usually black). The operation of the generator system will now be described with reference to these pedals, and to the diagram in figure 16.
Si el cirujano está utilizando el instrumento electroquirúrgico conectado al generador solamente para coagular tejido, la activación del pedal de coagulación (16B) provocará que sea suministrada al instrumento una forma de onda 100% de coagulación. Sin embargo, cuando el cirujano desea utilizar el instrumento para cortar tejido, el pedal de corte (16A) es activado. Cuando el pedal de corte es activado, el generador proporciona una forma de onda al instrumento, según una configuración inicial predeterminada, en este caso una forma de onda de 100% de coagulación tal como se muestra en "A". A medida que son suministrados sucesivos impulsos de energía al instrumento, la forma de onda cambia según una evolución predeterminada, hasta que en "(B)" la forma de onda es del 50% de corte y del 50% de coagulación. Pasado el tiempo (t1) la forma de onda ha evolucionado a su configuración final tal como la mostrada en "(C)", que en este caso es una forma de onda constituida por formas de onda del 90% de corte y del 10% coagulación. Esta configuración final será aplicada al instrumento hasta que sea liberado el pedal (16B) de corte.If the surgeon is using the instrument electrosurgical connected to the generator only to coagulate tissue, the activation of the coagulation pedal (16B) will cause a 100% waveform is supplied to the instrument coagulation. However, when the surgeon wishes to use the tissue cutting instrument, the cutting pedal (16A) is activated. When the cutting pedal is activated, the generator provides a waveform to the instrument, according to a initial default setting, in this case a waveform 100% coagulation as shown in "A". Custom that successive energy pulses are supplied to the instrument, the waveform changes according to a predetermined evolution, up to that in "(B)" the waveform is 50% cut and 50% of coagulation. Time passed (t1) the waveform has evolved to its final configuration as shown in "(C)", which in this case is a waveform consisting of waveforms of the 90% cut and 10% coagulation. This final configuration will be applied to the instrument until the pedal (16B) is released from cut.
Esta evolución de la forma de onda desde una configuración inicial hasta una configuración final tiene varias ventajas para el cirujano. En primer lugar, cuando se utiliza el instrumento para cortar tejido grueso, a menudo se produce hemorragia. Esto no siempre puede compensarse coagulando tejido grueso antes del corte, puesto que existe el riesgo de que para asegurar que el tejido grueso sea coagulado, parte del tejido resultará "sobrecoagulado" y deshidratado. El tejido deshidratado no es receptivo a la energía de RF, y por lo tanto el subsiguiente corte del tejido no será eficaz. De este modo, la hemorragia está a menudo asociada con el corte de tejido grueso. En la presente disposición, el instrumento mantiene un elemento de coagulación, especialmente en el comienzo del proceso. De este modo, si el cirujano encuentra hemorragia durante el corte electroquirúrgico, el cirujano suelta y a continuación reactiva el pedal (16B) de corte. Esto reajusta la evolución al punto "A" en la figura 16, con un alto grado de coagulación con la configuración inicial.This evolution of the waveform from a initial configuration until a final configuration has several Advantages for the surgeon. First, when you use the Thick tissue cutting instrument, often produced hemorrhage. This cannot always be compensated by coagulating tissue. thick before cutting, since there is a risk that for ensure that the thick tissue is coagulated, part of the tissue It will be "overcoagulated" and dehydrated. The tissue dehydrated is not receptive to RF energy, and therefore the Subsequent tissue cutting will not be effective. In this way, the Hemorrhage is often associated with cutting thick tissue. In In this provision, the instrument maintains an element of coagulation, especially at the beginning of the process. Of this mode, if the surgeon finds bleeding during the cut electrosurgical, the surgeon releases and then reactivates the cutting pedal (16B). This resets the evolution to point "A" in figure 16, with a high degree of coagulation with the initial setup.
En segundo lugar, la proporción creciente de la forma de onda de corte asegura que el corte de tejido es eficaz en cuanto es posible que esto ocurra. Mantener por lo menos una proporción del 10% de la forma de onda de coagulación asegura que la coagulación sigue produciéndose cuando el instrumento se mueve a través del tejido.Second, the increasing proportion of the Cut waveform ensures that tissue cutting is effective in How much is possible that this happens. Maintain at least one 10% proportion of the coagulation waveform ensures that coagulation continues to occur when the instrument moves to through the tissue.
El tiempo que lleva al generador evolucionar desde la configuración inicial hasta la configuración final puede variarse dependiendo del tipo de instrumento conectado al generador, y/o del tipo de tejido tratado típicamente por tal instrumento. El tiempo de evolución puede ser un ajuste de fábrica, o puede ser ajustable por el usuario utilizando el pedal (16C) de ajuste de modo. El tiempo de evolución es típicamente del orden de 7,5 segundos, aunque en circunstancias apropiadas pueden ser utilizados tiempos de evolución de tan solo 0,5 segundos o de hasta 10 segundos.The time it takes for the generator to evolve from initial configuration to final configuration you can vary depending on the type of instrument connected to the generator, and / or the type of tissue typically treated by such an instrument. He evolution time can be a factory setting, or it can be user adjustable using the pedal (16C) adjustment mode. The evolution time is typically of the order of 7.5 seconds, although under appropriate circumstances they can be used evolution times of only 0.5 seconds or up to 10 seconds.
El tiempo de evolución desde la configuración inicial hasta la configuración final puede no necesariamente ser una evolución uniforme tal como se muestra en la figura 16. Por ejemplo, la forma de onda puede permanecer con un contenido de coagulación del 100% durante un tiempo predeterminado (por ejemplo 1,5 segundos) antes de evolucionar a la configuración final de 90% de corte y 10% de coagulación. Esta es la situación mostrada en la figura 17. Un experto apreciará que serán posibles diferentes evoluciones desde la configuración inicial hasta la configuración final, dependiendo del tipo de operación que se esté llevando a cabo.The evolution time from the configuration initial until final configuration may not necessarily be a uniform evolution as shown in figure 16. By For example, the waveform can remain with a content of 100% coagulation for a predetermined time (for example 1.5 seconds) before evolving to the final configuration of 90% cutting and 10% coagulation. This is the situation shown in the Figure 17. An expert will appreciate that different ones will be possible evolutions from initial configuration to configuration final, depending on the type of operation that is being carried out to cape.
Las figuras 18 a 22 muestran un tipo de instrumento alternativo que puede ser utilizado junto con el generador electroquirúrgico descrito previamente. En relación con la figura 18, un dispositivo fórceps bipolar incluye un eje tubular alargado (101) con un extremo proximal (102), un extremo distal (103) y un lumen (104) que se extiende por toda la longitud del elemento tubular. En el extremo proximal (102) del elemento tubular (101) hay un conjunto de empuñaduras (105) de tipo tijeras con una primera empuñadura (106) y una segunda empuñadura (107). La segunda empuñadura (107) puede ser pivotada con respecto a la primera, en torno a la clavija (108) de pivote. En un diseño conocido de mecanismo de activación, la segunda empuñadura (107) tiene una clavija (109) unida a la parte superior de la misma, de manera que el movimiento de la empuñadura provoca un movimiento correspondiente en una esfera (110) soportada en un soporte (111) con forma de U.Figures 18 to 22 show a type of alternative instrument that can be used together with the electrosurgical generator previously described. Regarding Figure 18, a bipolar forceps device includes a tubular shaft elongated (101) with a proximal end (102), a distal end (103) and a lumen (104) that extends over the entire length of the tubular element At the proximal end (102) of the tubular element (101) there is a set of handles (105) of scissors type with a first handle (106) and a second handle (107). The second handle (107) can be pivoted with respect to the first, in around the pivot pin (108). In a known design of activation mechanism, the second handle (107) has a plug (109) attached to the top of it, so that the movement of the handle causes a movement corresponding on a sphere (110) supported on a support (111) U-shaped
Montado en el extremo distal (103) del elemento tubular (101) está el conjunto (112) de mandíbulas de fórceps, que se muestra de forma más específica en la figura 19. El conjunto (112) de mandíbulas comprende un primer elemento de mandíbula (113) y un segundo elemento de mandíbula (114), unidos entre sí de forma pivotante mediante un remache aislado (115). El elemento de mandíbula (113) está dotado de un electrodo (116) de corte, aislado respecto del elemento de mandíbula (113) mediante un aislante cerámico (117). Tal como se muestra en la figura 20, tres varillas rígidas (118), (119) y (120) eléctricamente conductoras, cada una cubierta con una capa de aislamiento eléctrico, se extienden a través del lumen (104) del elemento tubular (101). Las varillas (118), (119) están conectadas de manera pivotante a los respectivos elementos de mandíbula (113), (114) mediante conexiones rígidas (121), mientras que la varilla (120) está conectada por medio de un cable (124) (que se muestra mejor en la figura 22) al electrodo (116). Los extremos proximales de las varillas (118), (119) y (120) se extienden desde el elemento tubular a través de la esfera (110) y terminan en un conector (122), mediante el cual el dispositivo puede ser conectado al generador electroquirúrgico (10).Mounted on the distal end (103) of the element tubular (101) is the set (112) of forceps jaws, which is shown more specifically in figure 19. The set (112) of jaws comprises a first jaw element (113) and a second jaw element (114), joined together in a manner pivoting by means of an isolated rivet (115). The element of jaw (113) is provided with a cutting electrode (116), isolated with respect to the jaw element (113) by means of an insulator ceramic (117). As shown in Figure 20, three rods rigid (118), (119) and (120) electrically conductive, each covered with a layer of electrical insulation, extend to through the lumen (104) of the tubular element (101). Rods (118), (119) are pivotally connected to the respective jaw elements (113), (114) by rigid connections (121), while the rod (120) is connected by means of a cable (124) (best shown in figure 22) to the electrode (116). The proximal ends of the rods (118), (119) and (120) they extend from the tubular element through the sphere (110) and terminate in a connector (122), by which the device It can be connected to the electrosurgical generator (10).
Tal como se muestra en la figura 19, el electrodo de corte (116) tiene la forma de un raíl alargado, que se extiende a lo largo de la longitud del elemento de mandíbula (113). El raíl (116) está montado sobre el aislante cerámico (117) de manera que está aislado respecto del elemento de mandíbula (113). El raíl (116) es típicamente de 100 micras de anchura, y sobresale desde el aislante cerámico (117) en una distancia de aproximadamente 50 micras. Cuando el conjunto de mandíbulas (112) está en su posición cerrada, el raíl (116) es recibido en un rebaje longitudinal (123) correspondiente en el elemento de mandíbula (114), tal como se muestra mejor en la figura 21. En el rebaje (123) está dispuesta una tira comprimible (127) de material de aislamiento.As shown in Figure 19, the cutting electrode (116) is in the form of an elongated rail, which extends along the length of the jaw element (113). The rail (116) is mounted on the ceramic insulator (117) of way that is isolated from the jaw element (113). He rail (116) is typically 100 microns wide, and protrudes from the ceramic insulator (117) at a distance of approximately 50 microns When the jaw assembly (112) is in its closed position, the rail (116) is received in a recess corresponding longitudinal (123) in the jaw element (114), as best shown in Figure 21. In the recess (123) a compressible strip (127) of material of isolation.
A continuación se describirá en mayor detalle el funcionamiento del dispositivo. Cuando se va a cortar tejido, el conjunto (112) de mandíbulas se acerca al tejido a cortar, con el conjunto de mandíbulas en su posición abierta y el tejido en la línea de tangencia (125) del conjunto de mandíbulas. Una forma de onda de corte procedente del generador electroquirúrgico (10) es suministrada a través de la varilla (120) al electrodo (116) de corte, y el dispositivo de fórceps es movido longitudinalmente en la dirección de la flecha mostrada en la figura 22. El tejido que está situado entre el electrodo de corte (116) y uno o ambos elementos (113) y (114) de mandíbula es cortado por la forma de onda electroquirúrgica a medida que el dispositivo es trasladado longitudinalmente, formando de ese modo una línea de corte longitudinal en el tejido. El conjunto de mandíbulas es mantenido en su posición abierta durante todo este proceso, definiendo la línea de tangencia (125) en la que el tejido es forzado.The following will describe in more detail the device operation. When tissue is to be cut, the set (112) of jaws approaches the tissue to be cut, with the set of jaws in their open position and tissue in the tangency line (125) of the jaw assembly. A form of cut-off wave from the electrosurgical generator (10) is supplied through the rod (120) to the electrode (116) of cut, and the forceps device is moved longitudinally in the direction of the arrow shown in figure 22. The fabric that is located between the cutting electrode (116) and one or both elements (113) and (114) jaw is cut by the waveform electrosurgical as the device is transferred longitudinally, thereby forming a cutting line longitudinal in the tissue. The set of jaws is maintained in its open position throughout this process, defining the line of tangency (125) in which the tissue is forced.
El dispositivo puede ser utilizado también para coagular tejido, de un modo más convencional, utilizando el conjunto de mandíbulas en su posición cerrada. El conjunto de mandíbulas es cerrado, capturando tejido entre el elemento de mandíbula (113) y el elemento de mandíbula (114). El raíl de corte (116) es recibido en el rebaje (123) y, sin la forma de onda de corte electroquirúrgico descrita previamente, no tiene un efecto de corte sobre el tejido entre ambos. Una forma de onda de coagulación procedente del generador electroquirúrgico (10) es suministrada entre los elementos (113) y (114) de mandíbula, a través de varillas (118) y (119). Esto provoca la coagulación del tejido contenido entre las mandíbulas.The device can also be used for coagulate tissue, in a more conventional way, using the jaw set in its closed position. The set of jaws is closed, capturing tissue between the element of jaw (113) and the jaw element (114). Cutting rail (116) is received in the recess (123) and, without the waveform of Electrosurgical cut described previously, does not have an effect of cut over the tissue between them. A coagulation waveform from the electrosurgical generator (10) is supplied between the elements (113) and (114) of the jaw, through rods (118) and (119). This causes coagulation of the contained tissue Between the jaws
El dispositivo puede también ser utilizado para cortar y coagular simultáneamente tejido, utilizando una forma de onda mixta tal como se ha descrito previamente. Igual que anteriormente, el conjunto de mandíbulas es cerrado, capturando tejido entre el elemento de mandíbula (113) y el elemento de mandíbula (114). El cirujano presiona el pedal (16B) de corte en el conmutador de pedal (16), y se suministra una forma de onda electroquirúrgica que consiste en la configuración inicial (100% de coagulación) a los elementos (113) y (114) de mandíbula. La forma de onda evoluciona, tal como se ha descrito previamente, de manera que se incluye una proporción creciente de la forma de onda de corte, siendo suministrada la forma de onda de corte entre el raíl (116) de corte y las mandíbulas (113) y (114). Tras un periodo de tiempo predeterminado, la forma de onda alcanza su configuración final (90% de corte y 10% de coagulación), que continúa hasta que se libera el pedal (16B) de corte.The device can also be used to simultaneously cut and coagulate tissue, using a form of mixed wave as previously described. Like previously, the jaw set is closed, capturing tissue between the jaw element (113) and the element of jaw (114). The surgeon presses the cutting pedal (16B) into the footswitch (16), and a waveform is supplied electrosurgical consisting of the initial configuration (100% of coagulation) to the jaw elements (113) and (114). The shape wave evolves, as previously described, so that an increasing proportion of the waveform of cut, the cut waveform being supplied between the rail (116) cutting and jaws (113) and (114). After a period of default time, the waveform reaches its configuration final (90% cut and 10% coagulation), which continues until it releases the cutting pedal (16B).
Claims (16)
- (i) (i)
- una etapa de salida de radiofrecuencia que tiene tres o más conexiones de salida (48, 49, 50; 133, 134, 135);a radio frequency output stage that has three or more output connections (48, 49, 50; 133, 134, 135);
- (ii) (ii)
- una o más fuentes de potencia de salida de radiofrecuencia acopladas a la etapa de salida,one or more output power sources of radio frequency coupled to the output stage,
- (iii) (iii)
- un controlador operativo para provocar que el sistema suministre potencia en un modo combinado en el que una primera forma de onda de RF de corte y una segunda forma de onda de RF de coagulación son distribuidas a las conexiones de salida, incluyendo el controlador medios para alimentar las formas de onda a las conexiones de salida de manera que la primera forma de onda de RF es distribuida entre un primer par de las conexiones de salida, y la segunda forma de onda de RF es distribuida entre un segundo par de las conexiones de salida,an operating driver to cause the system supply power in a combined mode in which a first cut-off RF waveform and a second waveform of RF coagulation are distributed to the output connections, including the controller means to feed the waveforms to the output connections so that the first waveform of RF is distributed among a first pair of the output connections, and the second RF waveform is distributed between a second pair of the output connections,
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- (i) (i)
- un instrumento electroquirúrgico bipolar que incluye una empuñadura (105), un conjunto (112) de mandíbulas dispuesto de manera que la manipulación de la empuñadura permite que las mandíbulas opuestas del conjunto de mandíbulas se abran y se cierren una con respecto a otra; teniendo una primera de las mencionadas mandíbulas opuestas por lo menos un primer electrodo (114) de coagulación; teniendo la otra de las mencionadas mandíbulas opuestas por lo menos un segundo electrodo (113) de coagulación; y un electrodo (116) de corte, estando el electrodo de corte separado del segundo electrodo de coagulación por medio de un elemento (117) aislante, ya bipolar electrosurgical instrument that includes a handle (105), a set (112) of jaws disposed of so that the manipulation of the handle allows the opposite jaws of the jaw set open and close one with respect to another; having a first of those mentioned opposite jaws at least one first electrode (114) of coagulation; having the other one of the mentioned opposite jaws at least a second coagulation electrode (113); and a cutting electrode (116), the cutting electrode being separated of the second coagulation electrode by means of an element (117) insulator, and
- (ii) (ii)
- un aparato (10) generador electroquirúrgico que comprende una o más fuentes de potencia de salida de RF, un controlador operativo para controlar el generador de manera que pueda proporcionar una primera forma de onda de RF de corte al instrumento electroquirúrgico o una segunda forma de onda de RF de coagulación al instrumento electroquirúrgico, y, en un modo combinado, suministrar ambas primera y segunda formas de onda de RF, siendo las formas de onda alimentadas al instrumento electroquirúrgico de manera que, en el modo combinado, la forma de onda de RF de corte es suministrada entre el electrodo (116) de corte y por lo menos uno de los primero y segundo electrodos (114, 113) de coagulación, y la forma de onda de RF de coagulación es suministrada entre los primero y segundo electrodos de coagulación, siendo el modo combinado ajustable entre diversas configuraciones, teniendo cada configuración una proporción diferente de las primera y segunda formas de onda de RF,an electrosurgical generator apparatus (10) that comprises one or more sources of RF output power, a operating controller to control the generator so that can provide a first cut-off RF waveform to the electrosurgical instrument or a second RF waveform of coagulation to the electrosurgical instrument, and, in a way combined, supply both first and second RF waveforms, the waveforms being fed to the instrument electrosurgical so that, in the combined mode, the form of RF cutoff wave is supplied between electrode (116) of cut and at least one of the first and second electrodes (114, 113) coagulation, and the coagulation RF waveform is supplied between the first and second coagulation electrodes, the combined mode being adjustable between different configurations, each configuration having a different proportion of the first and second RF waveforms,
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---|---|---|---|---|
US7282048B2 (en) * | 2001-08-27 | 2007-10-16 | Gyrus Medical Limited | Electrosurgical generator and system |
US8043286B2 (en) | 2002-05-03 | 2011-10-25 | The Board Of Trustees Of The Leland Stanford Junior University | Method and apparatus for plasma-mediated thermo-electrical ablation |
US6780178B2 (en) | 2002-05-03 | 2004-08-24 | The Board Of Trustees Of The Leland Stanford Junior University | Method and apparatus for plasma-mediated thermo-electrical ablation |
US7736361B2 (en) | 2003-02-14 | 2010-06-15 | The Board Of Trustees Of The Leland Stamford Junior University | Electrosurgical system with uniformly enhanced electric field and minimal collateral damage |
US20070084897A1 (en) | 2003-05-20 | 2007-04-19 | Shelton Frederick E Iv | Articulating surgical stapling instrument incorporating a two-piece e-beam firing mechanism |
US9060770B2 (en) | 2003-05-20 | 2015-06-23 | Ethicon Endo-Surgery, Inc. | Robotically-driven surgical instrument with E-beam driver |
US9072535B2 (en) | 2011-05-27 | 2015-07-07 | Ethicon Endo-Surgery, Inc. | Surgical stapling instruments with rotatable staple deployment arrangements |
US11890012B2 (en) | 2004-07-28 | 2024-02-06 | Cilag Gmbh International | Staple cartridge comprising cartridge body and attached support |
US8905977B2 (en) | 2004-07-28 | 2014-12-09 | Ethicon Endo-Surgery, Inc. | Surgical stapling instrument having an electroactive polymer actuated medical substance dispenser |
US8215531B2 (en) | 2004-07-28 | 2012-07-10 | Ethicon Endo-Surgery, Inc. | Surgical stapling instrument having a medical substance dispenser |
US11998198B2 (en) | 2004-07-28 | 2024-06-04 | Cilag Gmbh International | Surgical stapling instrument incorporating a two-piece E-beam firing mechanism |
US10159482B2 (en) | 2005-08-31 | 2018-12-25 | Ethicon Llc | Fastener cartridge assembly comprising a fixed anvil and different staple heights |
US20070194082A1 (en) | 2005-08-31 | 2007-08-23 | Morgan Jerome R | Surgical stapling device with anvil having staple forming pockets of varying depths |
US7934630B2 (en) | 2005-08-31 | 2011-05-03 | Ethicon Endo-Surgery, Inc. | Staple cartridges for forming staples having differing formed staple heights |
US9237891B2 (en) | 2005-08-31 | 2016-01-19 | Ethicon Endo-Surgery, Inc. | Robotically-controlled surgical stapling devices that produce formed staples having different lengths |
US11484312B2 (en) | 2005-08-31 | 2022-11-01 | Cilag Gmbh International | Staple cartridge comprising a staple driver arrangement |
US7669746B2 (en) | 2005-08-31 | 2010-03-02 | Ethicon Endo-Surgery, Inc. | Staple cartridges for forming staples having differing formed staple heights |
US8800838B2 (en) | 2005-08-31 | 2014-08-12 | Ethicon Endo-Surgery, Inc. | Robotically-controlled cable-based surgical end effectors |
US11246590B2 (en) | 2005-08-31 | 2022-02-15 | Cilag Gmbh International | Staple cartridge including staple drivers having different unfired heights |
US20070106317A1 (en) | 2005-11-09 | 2007-05-10 | Shelton Frederick E Iv | Hydraulically and electrically actuated articulation joints for surgical instruments |
US20110290856A1 (en) | 2006-01-31 | 2011-12-01 | Ethicon Endo-Surgery, Inc. | Robotically-controlled surgical instrument with force-feedback capabilities |
US20120292367A1 (en) | 2006-01-31 | 2012-11-22 | Ethicon Endo-Surgery, Inc. | Robotically-controlled end effector |
US11793518B2 (en) | 2006-01-31 | 2023-10-24 | Cilag Gmbh International | Powered surgical instruments with firing system lockout arrangements |
US8820603B2 (en) | 2006-01-31 | 2014-09-02 | Ethicon Endo-Surgery, Inc. | Accessing data stored in a memory of a surgical instrument |
US8161977B2 (en) | 2006-01-31 | 2012-04-24 | Ethicon Endo-Surgery, Inc. | Accessing data stored in a memory of a surgical instrument |
US8186555B2 (en) | 2006-01-31 | 2012-05-29 | Ethicon Endo-Surgery, Inc. | Motor-driven surgical cutting and fastening instrument with mechanical closure system |
US8763879B2 (en) | 2006-01-31 | 2014-07-01 | Ethicon Endo-Surgery, Inc. | Accessing data stored in a memory of surgical instrument |
US20110006101A1 (en) | 2009-02-06 | 2011-01-13 | EthiconEndo-Surgery, Inc. | Motor driven surgical fastener device with cutting member lockout arrangements |
US8708213B2 (en) | 2006-01-31 | 2014-04-29 | Ethicon Endo-Surgery, Inc. | Surgical instrument having a feedback system |
US7845537B2 (en) | 2006-01-31 | 2010-12-07 | Ethicon Endo-Surgery, Inc. | Surgical instrument having recording capabilities |
US20110024477A1 (en) | 2009-02-06 | 2011-02-03 | Hall Steven G | Driven Surgical Stapler Improvements |
US11278279B2 (en) | 2006-01-31 | 2022-03-22 | Cilag Gmbh International | Surgical instrument assembly |
US7753904B2 (en) | 2006-01-31 | 2010-07-13 | Ethicon Endo-Surgery, Inc. | Endoscopic surgical instrument with a handle that can articulate with respect to the shaft |
US11224427B2 (en) | 2006-01-31 | 2022-01-18 | Cilag Gmbh International | Surgical stapling system including a console and retraction assembly |
US9861359B2 (en) | 2006-01-31 | 2018-01-09 | Ethicon Llc | Powered surgical instruments with firing system lockout arrangements |
US8236010B2 (en) | 2006-03-23 | 2012-08-07 | Ethicon Endo-Surgery, Inc. | Surgical fastener and cutter with mimicking end effector |
US8992422B2 (en) | 2006-03-23 | 2015-03-31 | Ethicon Endo-Surgery, Inc. | Robotically-controlled endoscopic accessory channel |
US8322455B2 (en) | 2006-06-27 | 2012-12-04 | Ethicon Endo-Surgery, Inc. | Manually driven surgical cutting and fastening instrument |
US7740159B2 (en) | 2006-08-02 | 2010-06-22 | Ethicon Endo-Surgery, Inc. | Pneumatically powered surgical cutting and fastening instrument with a variable control of the actuating rate of firing with mechanical power assist |
US10568652B2 (en) | 2006-09-29 | 2020-02-25 | Ethicon Llc | Surgical staples having attached drivers of different heights and stapling instruments for deploying the same |
US20110087276A1 (en) | 2009-10-09 | 2011-04-14 | Ethicon Endo-Surgery, Inc. | Method for forming a staple |
US7794475B2 (en) | 2006-09-29 | 2010-09-14 | Ethicon Endo-Surgery, Inc. | Surgical staples having compressible or crushable members for securing tissue therein and stapling instruments for deploying the same |
US10130359B2 (en) | 2006-09-29 | 2018-11-20 | Ethicon Llc | Method for forming a staple |
US11980366B2 (en) | 2006-10-03 | 2024-05-14 | Cilag Gmbh International | Surgical instrument |
US8177783B2 (en) | 2006-11-02 | 2012-05-15 | Peak Surgical, Inc. | Electric plasma-mediated cutting and coagulation of tissue and surgical apparatus |
US8652120B2 (en) | 2007-01-10 | 2014-02-18 | Ethicon Endo-Surgery, Inc. | Surgical instrument with wireless communication between control unit and sensor transponders |
US11291441B2 (en) | 2007-01-10 | 2022-04-05 | Cilag Gmbh International | Surgical instrument with wireless communication between control unit and remote sensor |
US8840603B2 (en) | 2007-01-10 | 2014-09-23 | Ethicon Endo-Surgery, Inc. | Surgical instrument with wireless communication between control unit and sensor transponders |
US8459520B2 (en) | 2007-01-10 | 2013-06-11 | Ethicon Endo-Surgery, Inc. | Surgical instrument with wireless communication between control unit and remote sensor |
US8684253B2 (en) | 2007-01-10 | 2014-04-01 | Ethicon Endo-Surgery, Inc. | Surgical instrument with wireless communication between a control unit of a robotic system and remote sensor |
US11039836B2 (en) | 2007-01-11 | 2021-06-22 | Cilag Gmbh International | Staple cartridge for use with a surgical stapling instrument |
US20080169332A1 (en) | 2007-01-11 | 2008-07-17 | Shelton Frederick E | Surgical stapling device with a curved cutting member |
US7673782B2 (en) | 2007-03-15 | 2010-03-09 | Ethicon Endo-Surgery, Inc. | Surgical stapling instrument having a releasable buttress material |
US8893946B2 (en) | 2007-03-28 | 2014-11-25 | Ethicon Endo-Surgery, Inc. | Laparoscopic tissue thickness and clamp load measuring devices |
GB0709994D0 (en) * | 2007-05-24 | 2007-07-04 | Gyrus Medical Ltd | Electrosurgical generator |
US8157145B2 (en) | 2007-05-31 | 2012-04-17 | Ethicon Endo-Surgery, Inc. | Pneumatically powered surgical cutting and fastening instrument with electrical feedback |
US7905380B2 (en) | 2007-06-04 | 2011-03-15 | Ethicon Endo-Surgery, Inc. | Surgical instrument having a multiple rate directional switching mechanism |
US8931682B2 (en) | 2007-06-04 | 2015-01-13 | Ethicon Endo-Surgery, Inc. | Robotically-controlled shaft based rotary drive systems for surgical instruments |
US8534528B2 (en) | 2007-06-04 | 2013-09-17 | Ethicon Endo-Surgery, Inc. | Surgical instrument having a multiple rate directional switching mechanism |
US11857181B2 (en) | 2007-06-04 | 2024-01-02 | Cilag Gmbh International | Robotically-controlled shaft based rotary drive systems for surgical instruments |
US7832408B2 (en) | 2007-06-04 | 2010-11-16 | Ethicon Endo-Surgery, Inc. | Surgical instrument having a directional switching mechanism |
US7753245B2 (en) | 2007-06-22 | 2010-07-13 | Ethicon Endo-Surgery, Inc. | Surgical stapling instruments |
US8408439B2 (en) | 2007-06-22 | 2013-04-02 | Ethicon Endo-Surgery, Inc. | Surgical stapling instrument with an articulatable end effector |
US11849941B2 (en) | 2007-06-29 | 2023-12-26 | Cilag Gmbh International | Staple cartridge having staple cavities extending at a transverse angle relative to a longitudinal cartridge axis |
US8540133B2 (en) | 2008-09-19 | 2013-09-24 | Ethicon Endo-Surgery, Inc. | Staple cartridge |
US7766209B2 (en) | 2008-02-13 | 2010-08-03 | Ethicon Endo-Surgery, Inc. | Surgical stapling instrument with improved firing trigger arrangement |
US8453908B2 (en) | 2008-02-13 | 2013-06-04 | Ethicon Endo-Surgery, Inc. | Surgical stapling instrument with improved firing trigger arrangement |
US8561870B2 (en) | 2008-02-13 | 2013-10-22 | Ethicon Endo-Surgery, Inc. | Surgical stapling instrument |
US7905381B2 (en) | 2008-09-19 | 2011-03-15 | Ethicon Endo-Surgery, Inc. | Surgical stapling instrument with cutting member arrangement |
US7793812B2 (en) | 2008-02-14 | 2010-09-14 | Ethicon Endo-Surgery, Inc. | Disposable motor-driven loading unit for use with a surgical cutting and stapling apparatus |
US8622274B2 (en) | 2008-02-14 | 2014-01-07 | Ethicon Endo-Surgery, Inc. | Motorized cutting and fastening instrument having control circuit for optimizing battery usage |
US9179912B2 (en) | 2008-02-14 | 2015-11-10 | Ethicon Endo-Surgery, Inc. | Robotically-controlled motorized surgical cutting and fastening instrument |
US8752749B2 (en) | 2008-02-14 | 2014-06-17 | Ethicon Endo-Surgery, Inc. | Robotically-controlled disposable motor-driven loading unit |
US11986183B2 (en) | 2008-02-14 | 2024-05-21 | Cilag Gmbh International | Surgical cutting and fastening instrument comprising a plurality of sensors to measure an electrical parameter |
US8758391B2 (en) | 2008-02-14 | 2014-06-24 | Ethicon Endo-Surgery, Inc. | Interchangeable tools for surgical instruments |
US8636736B2 (en) | 2008-02-14 | 2014-01-28 | Ethicon Endo-Surgery, Inc. | Motorized surgical cutting and fastening instrument |
US7819298B2 (en) | 2008-02-14 | 2010-10-26 | Ethicon Endo-Surgery, Inc. | Surgical stapling apparatus with control features operable with one hand |
US8459525B2 (en) | 2008-02-14 | 2013-06-11 | Ethicon Endo-Sugery, Inc. | Motorized surgical cutting and fastening instrument having a magnetic drive train torque limiting device |
US7866527B2 (en) | 2008-02-14 | 2011-01-11 | Ethicon Endo-Surgery, Inc. | Surgical stapling apparatus with interlockable firing system |
US8657174B2 (en) | 2008-02-14 | 2014-02-25 | Ethicon Endo-Surgery, Inc. | Motorized surgical cutting and fastening instrument having handle based power source |
US8573465B2 (en) | 2008-02-14 | 2013-11-05 | Ethicon Endo-Surgery, Inc. | Robotically-controlled surgical end effector system with rotary actuated closure systems |
US8584919B2 (en) | 2008-02-14 | 2013-11-19 | Ethicon Endo-Sugery, Inc. | Surgical stapling apparatus with load-sensitive firing mechanism |
RU2493788C2 (en) | 2008-02-14 | 2013-09-27 | Этикон Эндо-Серджери, Инк. | Surgical cutting and fixing instrument, which has radio-frequency electrodes |
US20090206131A1 (en) | 2008-02-15 | 2009-08-20 | Ethicon Endo-Surgery, Inc. | End effector coupling arrangements for a surgical cutting and stapling instrument |
US9615826B2 (en) | 2010-09-30 | 2017-04-11 | Ethicon Endo-Surgery, Llc | Multiple thickness implantable layers for surgical stapling devices |
US20090206139A1 (en) | 2008-02-15 | 2009-08-20 | Ethicon Endo-Surgery, Inc. | Buttress material for a surgical instrument |
US11272927B2 (en) | 2008-02-15 | 2022-03-15 | Cilag Gmbh International | Layer arrangements for surgical staple cartridges |
US8608044B2 (en) | 2008-02-15 | 2013-12-17 | Ethicon Endo-Surgery, Inc. | Feedback and lockout mechanism for surgical instrument |
US8083120B2 (en) | 2008-09-18 | 2011-12-27 | Ethicon Endo-Surgery, Inc. | End effector for use with a surgical cutting and stapling instrument |
PL3476312T3 (en) | 2008-09-19 | 2024-03-11 | Ethicon Llc | Surgical stapler with apparatus for adjusting staple height |
US9050083B2 (en) | 2008-09-23 | 2015-06-09 | Ethicon Endo-Surgery, Inc. | Motorized surgical instrument |
US9386983B2 (en) | 2008-09-23 | 2016-07-12 | Ethicon Endo-Surgery, Llc | Robotically-controlled motorized surgical instrument |
US9005230B2 (en) | 2008-09-23 | 2015-04-14 | Ethicon Endo-Surgery, Inc. | Motorized surgical instrument |
US11648005B2 (en) | 2008-09-23 | 2023-05-16 | Cilag Gmbh International | Robotically-controlled motorized surgical instrument with an end effector |
US8210411B2 (en) | 2008-09-23 | 2012-07-03 | Ethicon Endo-Surgery, Inc. | Motor-driven surgical cutting instrument |
GB0817920D0 (en) | 2008-09-30 | 2008-11-05 | Gyrus Medical Ltd | Electrosurgical instrument and system |
US8394089B2 (en) | 2008-09-30 | 2013-03-12 | Gyrus Medical Limited | Electrosurgical instrument and system |
US8608045B2 (en) | 2008-10-10 | 2013-12-17 | Ethicon Endo-Sugery, Inc. | Powered surgical cutting and stapling apparatus with manually retractable firing system |
US8137345B2 (en) | 2009-01-05 | 2012-03-20 | Peak Surgical, Inc. | Electrosurgical devices for tonsillectomy and adenoidectomy |
US8485413B2 (en) | 2009-02-05 | 2013-07-16 | Ethicon Endo-Surgery, Inc. | Surgical stapling instrument comprising an articulation joint |
US8517239B2 (en) | 2009-02-05 | 2013-08-27 | Ethicon Endo-Surgery, Inc. | Surgical stapling instrument comprising a magnetic element driver |
US8397971B2 (en) | 2009-02-05 | 2013-03-19 | Ethicon Endo-Surgery, Inc. | Sterilizable surgical instrument |
US8414577B2 (en) | 2009-02-05 | 2013-04-09 | Ethicon Endo-Surgery, Inc. | Surgical instruments and components for use in sterile environments |
CA2751664A1 (en) | 2009-02-06 | 2010-08-12 | Ethicon Endo-Surgery, Inc. | Driven surgical stapler improvements |
WO2010089037A1 (en) * | 2009-02-06 | 2010-08-12 | Erbe Elektromedizin Gmbh | Hf surgery device |
US8444036B2 (en) | 2009-02-06 | 2013-05-21 | Ethicon Endo-Surgery, Inc. | Motor driven surgical fastener device with mechanisms for adjusting a tissue gap within the end effector |
US8066167B2 (en) | 2009-03-23 | 2011-11-29 | Ethicon Endo-Surgery, Inc. | Circular surgical stapling instrument with anvil locking system |
US8622275B2 (en) | 2009-11-19 | 2014-01-07 | Ethicon Endo-Surgery, Inc. | Circular stapler introducer with rigid distal end portion |
US8136712B2 (en) | 2009-12-10 | 2012-03-20 | Ethicon Endo-Surgery, Inc. | Surgical stapler with discrete staple height adjustment and tactile feedback |
US8220688B2 (en) | 2009-12-24 | 2012-07-17 | Ethicon Endo-Surgery, Inc. | Motor-driven surgical cutting instrument with electric actuator directional control assembly |
US8851354B2 (en) | 2009-12-24 | 2014-10-07 | Ethicon Endo-Surgery, Inc. | Surgical cutting instrument that analyzes tissue thickness |
US8267300B2 (en) | 2009-12-30 | 2012-09-18 | Ethicon Endo-Surgery, Inc. | Dampening device for endoscopic surgical stapler |
US8608046B2 (en) | 2010-01-07 | 2013-12-17 | Ethicon Endo-Surgery, Inc. | Test device for a surgical tool |
WO2011088387A2 (en) | 2010-01-15 | 2011-07-21 | Salient Surgical Technologies, Inc. | Electrosurgical devices, electrosurgical unit and methods of use thereof |
DE102010025298B4 (en) * | 2010-06-28 | 2023-06-15 | Celon Ag Medical Instruments | High frequency surgical device |
US8783543B2 (en) | 2010-07-30 | 2014-07-22 | Ethicon Endo-Surgery, Inc. | Tissue acquisition arrangements and methods for surgical stapling devices |
US8801735B2 (en) | 2010-07-30 | 2014-08-12 | Ethicon Endo-Surgery, Inc. | Surgical circular stapler with tissue retention arrangements |
US8789740B2 (en) | 2010-07-30 | 2014-07-29 | Ethicon Endo-Surgery, Inc. | Linear cutting and stapling device with selectively disengageable cutting member |
US8360296B2 (en) | 2010-09-09 | 2013-01-29 | Ethicon Endo-Surgery, Inc. | Surgical stapling head assembly with firing lockout for a surgical stapler |
US9289212B2 (en) | 2010-09-17 | 2016-03-22 | Ethicon Endo-Surgery, Inc. | Surgical instruments and batteries for surgical instruments |
US8632525B2 (en) | 2010-09-17 | 2014-01-21 | Ethicon Endo-Surgery, Inc. | Power control arrangements for surgical instruments and batteries |
US20120078244A1 (en) | 2010-09-24 | 2012-03-29 | Worrell Barry C | Control features for articulating surgical device |
US8733613B2 (en) | 2010-09-29 | 2014-05-27 | Ethicon Endo-Surgery, Inc. | Staple cartridge |
US10945731B2 (en) | 2010-09-30 | 2021-03-16 | Ethicon Llc | Tissue thickness compensator comprising controlled release and expansion |
US9332974B2 (en) | 2010-09-30 | 2016-05-10 | Ethicon Endo-Surgery, Llc | Layered tissue thickness compensator |
US9220501B2 (en) | 2010-09-30 | 2015-12-29 | Ethicon Endo-Surgery, Inc. | Tissue thickness compensators |
US9113864B2 (en) | 2010-09-30 | 2015-08-25 | Ethicon Endo-Surgery, Inc. | Surgical cutting and fastening instruments with separate and distinct fastener deployment and tissue cutting systems |
US11298125B2 (en) | 2010-09-30 | 2022-04-12 | Cilag Gmbh International | Tissue stapler having a thickness compensator |
US9848875B2 (en) | 2010-09-30 | 2017-12-26 | Ethicon Llc | Anvil layer attached to a proximal end of an end effector |
US9232941B2 (en) | 2010-09-30 | 2016-01-12 | Ethicon Endo-Surgery, Inc. | Tissue thickness compensator comprising a reservoir |
US9277919B2 (en) | 2010-09-30 | 2016-03-08 | Ethicon Endo-Surgery, Llc | Tissue thickness compensator comprising fibers to produce a resilient load |
US11925354B2 (en) | 2010-09-30 | 2024-03-12 | Cilag Gmbh International | Staple cartridge comprising staples positioned within a compressible portion thereof |
US9016542B2 (en) | 2010-09-30 | 2015-04-28 | Ethicon Endo-Surgery, Inc. | Staple cartridge comprising compressible distortion resistant components |
US9055941B2 (en) | 2011-09-23 | 2015-06-16 | Ethicon Endo-Surgery, Inc. | Staple cartridge including collapsible deck |
US11812965B2 (en) | 2010-09-30 | 2023-11-14 | Cilag Gmbh International | Layer of material for a surgical end effector |
US9364233B2 (en) | 2010-09-30 | 2016-06-14 | Ethicon Endo-Surgery, Llc | Tissue thickness compensators for circular surgical staplers |
US9320523B2 (en) | 2012-03-28 | 2016-04-26 | Ethicon Endo-Surgery, Llc | Tissue thickness compensator comprising tissue ingrowth features |
US9414838B2 (en) | 2012-03-28 | 2016-08-16 | Ethicon Endo-Surgery, Llc | Tissue thickness compensator comprised of a plurality of materials |
US9301753B2 (en) | 2010-09-30 | 2016-04-05 | Ethicon Endo-Surgery, Llc | Expandable tissue thickness compensator |
US9629814B2 (en) | 2010-09-30 | 2017-04-25 | Ethicon Endo-Surgery, Llc | Tissue thickness compensator configured to redistribute compressive forces |
US9307989B2 (en) | 2012-03-28 | 2016-04-12 | Ethicon Endo-Surgery, Llc | Tissue stapler having a thickness compensator incorportating a hydrophobic agent |
US8893949B2 (en) | 2010-09-30 | 2014-11-25 | Ethicon Endo-Surgery, Inc. | Surgical stapler with floating anvil |
RU2013119928A (en) | 2010-09-30 | 2014-11-10 | Этикон Эндо-Серджери, Инк. | A STAPLING SYSTEM CONTAINING A RETAINING MATRIX AND A LEVELING MATRIX |
US9314246B2 (en) | 2010-09-30 | 2016-04-19 | Ethicon Endo-Surgery, Llc | Tissue stapler having a thickness compensator incorporating an anti-inflammatory agent |
US9211120B2 (en) | 2011-04-29 | 2015-12-15 | Ethicon Endo-Surgery, Inc. | Tissue thickness compensator comprising a plurality of medicaments |
US8695866B2 (en) | 2010-10-01 | 2014-04-15 | Ethicon Endo-Surgery, Inc. | Surgical instrument having a power control circuit |
USD650074S1 (en) | 2010-10-01 | 2011-12-06 | Ethicon Endo-Surgery, Inc. | Surgical instrument |
US8632462B2 (en) | 2011-03-14 | 2014-01-21 | Ethicon Endo-Surgery, Inc. | Trans-rectum universal ports |
US8926598B2 (en) | 2011-03-15 | 2015-01-06 | Ethicon Endo-Surgery, Inc. | Surgical instruments with articulatable and rotatable end effector |
US9044229B2 (en) | 2011-03-15 | 2015-06-02 | Ethicon Endo-Surgery, Inc. | Surgical fastener instruments |
US8857693B2 (en) | 2011-03-15 | 2014-10-14 | Ethicon Endo-Surgery, Inc. | Surgical instruments with lockable articulating end effector |
US8800841B2 (en) | 2011-03-15 | 2014-08-12 | Ethicon Endo-Surgery, Inc. | Surgical staple cartridges |
US8540131B2 (en) | 2011-03-15 | 2013-09-24 | Ethicon Endo-Surgery, Inc. | Surgical staple cartridges with tissue tethers for manipulating divided tissue and methods of using same |
GB2489925B (en) * | 2011-04-07 | 2018-09-12 | Gyrus Medical Ltd | Electrosurgical generator |
AU2012250197B2 (en) | 2011-04-29 | 2017-08-10 | Ethicon Endo-Surgery, Inc. | Staple cartridge comprising staples positioned within a compressible portion thereof |
US11207064B2 (en) | 2011-05-27 | 2021-12-28 | Cilag Gmbh International | Automated end effector component reloading system for use with a robotic system |
US8979842B2 (en) | 2011-06-10 | 2015-03-17 | Medtronic Advanced Energy Llc | Wire electrode devices for tonsillectomy and adenoidectomy |
US9198661B2 (en) | 2011-09-06 | 2015-12-01 | Ethicon Endo-Surgery, Inc. | Stapling instrument comprising a plurality of staple cartridges stored therein |
US9050084B2 (en) | 2011-09-23 | 2015-06-09 | Ethicon Endo-Surgery, Inc. | Staple cartridge including collapsible deck arrangement |
US9044230B2 (en) | 2012-02-13 | 2015-06-02 | Ethicon Endo-Surgery, Inc. | Surgical cutting and fastening instrument with apparatus for determining cartridge and firing motion status |
US9078653B2 (en) | 2012-03-26 | 2015-07-14 | Ethicon Endo-Surgery, Inc. | Surgical stapling device with lockout system for preventing actuation in the absence of an installed staple cartridge |
US9198662B2 (en) | 2012-03-28 | 2015-12-01 | Ethicon Endo-Surgery, Inc. | Tissue thickness compensator having improved visibility |
BR112014024098B1 (en) | 2012-03-28 | 2021-05-25 | Ethicon Endo-Surgery, Inc. | staple cartridge |
JP6224070B2 (en) | 2012-03-28 | 2017-11-01 | エシコン・エンド−サージェリィ・インコーポレイテッドEthicon Endo−Surgery,Inc. | Retainer assembly including tissue thickness compensator |
JP6305979B2 (en) | 2012-03-28 | 2018-04-04 | エシコン・エンド−サージェリィ・インコーポレイテッドEthicon Endo−Surgery,Inc. | Tissue thickness compensator with multiple layers |
US9101358B2 (en) | 2012-06-15 | 2015-08-11 | Ethicon Endo-Surgery, Inc. | Articulatable surgical instrument comprising a firing drive |
US9101385B2 (en) | 2012-06-28 | 2015-08-11 | Ethicon Endo-Surgery, Inc. | Electrode connections for rotary driven surgical tools |
US20140001231A1 (en) | 2012-06-28 | 2014-01-02 | Ethicon Endo-Surgery, Inc. | Firing system lockout arrangements for surgical instruments |
US9282974B2 (en) | 2012-06-28 | 2016-03-15 | Ethicon Endo-Surgery, Llc | Empty clip cartridge lockout |
US9119657B2 (en) | 2012-06-28 | 2015-09-01 | Ethicon Endo-Surgery, Inc. | Rotary actuatable closure arrangement for surgical end effector |
US9028494B2 (en) | 2012-06-28 | 2015-05-12 | Ethicon Endo-Surgery, Inc. | Interchangeable end effector coupling arrangement |
US9072536B2 (en) | 2012-06-28 | 2015-07-07 | Ethicon Endo-Surgery, Inc. | Differential locking arrangements for rotary powered surgical instruments |
US11197671B2 (en) | 2012-06-28 | 2021-12-14 | Cilag Gmbh International | Stapling assembly comprising a lockout |
US9204879B2 (en) | 2012-06-28 | 2015-12-08 | Ethicon Endo-Surgery, Inc. | Flexible drive member |
US8747238B2 (en) | 2012-06-28 | 2014-06-10 | Ethicon Endo-Surgery, Inc. | Rotary drive shaft assemblies for surgical instruments with articulatable end effectors |
JP6290201B2 (en) | 2012-06-28 | 2018-03-07 | エシコン・エンド−サージェリィ・インコーポレイテッドEthicon Endo−Surgery,Inc. | Lockout for empty clip cartridge |
US9289256B2 (en) | 2012-06-28 | 2016-03-22 | Ethicon Endo-Surgery, Llc | Surgical end effectors having angled tissue-contacting surfaces |
US9125662B2 (en) | 2012-06-28 | 2015-09-08 | Ethicon Endo-Surgery, Inc. | Multi-axis articulating and rotating surgical tools |
US9561038B2 (en) | 2012-06-28 | 2017-02-07 | Ethicon Endo-Surgery, Llc | Interchangeable clip applier |
US20140001234A1 (en) | 2012-06-28 | 2014-01-02 | Ethicon Endo-Surgery, Inc. | Coupling arrangements for attaching surgical end effectors to drive systems therefor |
BR112014032776B1 (en) | 2012-06-28 | 2021-09-08 | Ethicon Endo-Surgery, Inc | SURGICAL INSTRUMENT SYSTEM AND SURGICAL KIT FOR USE WITH A SURGICAL INSTRUMENT SYSTEM |
US9386985B2 (en) | 2012-10-15 | 2016-07-12 | Ethicon Endo-Surgery, Llc | Surgical cutting instrument |
US9386984B2 (en) | 2013-02-08 | 2016-07-12 | Ethicon Endo-Surgery, Llc | Staple cartridge comprising a releasable cover |
US10092292B2 (en) | 2013-02-28 | 2018-10-09 | Ethicon Llc | Staple forming features for surgical stapling instrument |
MX364729B (en) | 2013-03-01 | 2019-05-06 | Ethicon Endo Surgery Inc | Surgical instrument with a soft stop. |
US20140246475A1 (en) | 2013-03-01 | 2014-09-04 | Ethicon Endo-Surgery, Inc. | Control methods for surgical instruments with removable implement portions |
MX368026B (en) | 2013-03-01 | 2019-09-12 | Ethicon Endo Surgery Inc | Articulatable surgical instruments with conductive pathways for signal communication. |
US20140263552A1 (en) | 2013-03-13 | 2014-09-18 | Ethicon Endo-Surgery, Inc. | Staple cartridge tissue thickness sensor system |
US9888919B2 (en) | 2013-03-14 | 2018-02-13 | Ethicon Llc | Method and system for operating a surgical instrument |
US9629629B2 (en) | 2013-03-14 | 2017-04-25 | Ethicon Endo-Surgey, LLC | Control systems for surgical instruments |
US9572577B2 (en) | 2013-03-27 | 2017-02-21 | Ethicon Endo-Surgery, Llc | Fastener cartridge comprising a tissue thickness compensator including openings therein |
US9795384B2 (en) | 2013-03-27 | 2017-10-24 | Ethicon Llc | Fastener cartridge comprising a tissue thickness compensator and a gap setting element |
US9332984B2 (en) | 2013-03-27 | 2016-05-10 | Ethicon Endo-Surgery, Llc | Fastener cartridge assemblies |
US9649110B2 (en) | 2013-04-16 | 2017-05-16 | Ethicon Llc | Surgical instrument comprising a closing drive and a firing drive operated from the same rotatable output |
BR112015026109B1 (en) | 2013-04-16 | 2022-02-22 | Ethicon Endo-Surgery, Inc | surgical instrument |
US9574644B2 (en) | 2013-05-30 | 2017-02-21 | Ethicon Endo-Surgery, Llc | Power module for use with a surgical instrument |
US9987006B2 (en) | 2013-08-23 | 2018-06-05 | Ethicon Llc | Shroud retention arrangement for sterilizable surgical instruments |
CN106028966B (en) | 2013-08-23 | 2018-06-22 | 伊西康内外科有限责任公司 | For the firing member restoring device of powered surgical instrument |
US20140171986A1 (en) | 2013-09-13 | 2014-06-19 | Ethicon Endo-Surgery, Inc. | Surgical Clip Having Comliant Portion |
US9839428B2 (en) | 2013-12-23 | 2017-12-12 | Ethicon Llc | Surgical cutting and stapling instruments with independent jaw control features |
US9687232B2 (en) | 2013-12-23 | 2017-06-27 | Ethicon Llc | Surgical staples |
US20150173756A1 (en) | 2013-12-23 | 2015-06-25 | Ethicon Endo-Surgery, Inc. | Surgical cutting and stapling methods |
US9681870B2 (en) | 2013-12-23 | 2017-06-20 | Ethicon Llc | Articulatable surgical instruments with separate and distinct closing and firing systems |
US9642620B2 (en) | 2013-12-23 | 2017-05-09 | Ethicon Endo-Surgery, Llc | Surgical cutting and stapling instruments with articulatable end effectors |
US9724092B2 (en) | 2013-12-23 | 2017-08-08 | Ethicon Llc | Modular surgical instruments |
US9962161B2 (en) | 2014-02-12 | 2018-05-08 | Ethicon Llc | Deliverable surgical instrument |
JP6462004B2 (en) | 2014-02-24 | 2019-01-30 | エシコン エルエルシー | Fastening system with launcher lockout |
US20140166725A1 (en) | 2014-02-24 | 2014-06-19 | Ethicon Endo-Surgery, Inc. | Staple cartridge including a barbed staple. |
US9733663B2 (en) | 2014-03-26 | 2017-08-15 | Ethicon Llc | Power management through segmented circuit and variable voltage protection |
US20150272580A1 (en) | 2014-03-26 | 2015-10-01 | Ethicon Endo-Surgery, Inc. | Verification of number of battery exchanges/procedure count |
BR112016021943B1 (en) | 2014-03-26 | 2022-06-14 | Ethicon Endo-Surgery, Llc | SURGICAL INSTRUMENT FOR USE BY AN OPERATOR IN A SURGICAL PROCEDURE |
US9913642B2 (en) | 2014-03-26 | 2018-03-13 | Ethicon Llc | Surgical instrument comprising a sensor system |
US10004497B2 (en) | 2014-03-26 | 2018-06-26 | Ethicon Llc | Interface systems for use with surgical instruments |
US10561422B2 (en) | 2014-04-16 | 2020-02-18 | Ethicon Llc | Fastener cartridge comprising deployable tissue engaging members |
JP6612256B2 (en) | 2014-04-16 | 2019-11-27 | エシコン エルエルシー | Fastener cartridge with non-uniform fastener |
US20150297222A1 (en) | 2014-04-16 | 2015-10-22 | Ethicon Endo-Surgery, Inc. | Fastener cartridges including extensions having different configurations |
CN106456176B (en) | 2014-04-16 | 2019-06-28 | 伊西康内外科有限责任公司 | Fastener cartridge including the extension with various configuration |
CN106456159B (en) | 2014-04-16 | 2019-03-08 | 伊西康内外科有限责任公司 | Fastener cartridge assembly and nail retainer lid arragement construction |
US10206677B2 (en) | 2014-09-26 | 2019-02-19 | Ethicon Llc | Surgical staple and driver arrangements for staple cartridges |
US10045781B2 (en) | 2014-06-13 | 2018-08-14 | Ethicon Llc | Closure lockout systems for surgical instruments |
US11311294B2 (en) | 2014-09-05 | 2022-04-26 | Cilag Gmbh International | Powered medical device including measurement of closure state of jaws |
US10111679B2 (en) | 2014-09-05 | 2018-10-30 | Ethicon Llc | Circuitry and sensors for powered medical device |
BR112017004361B1 (en) | 2014-09-05 | 2023-04-11 | Ethicon Llc | ELECTRONIC SYSTEM FOR A SURGICAL INSTRUMENT |
US10105142B2 (en) | 2014-09-18 | 2018-10-23 | Ethicon Llc | Surgical stapler with plurality of cutting elements |
US11523821B2 (en) | 2014-09-26 | 2022-12-13 | Cilag Gmbh International | Method for creating a flexible staple line |
BR112017005981B1 (en) | 2014-09-26 | 2022-09-06 | Ethicon, Llc | ANCHOR MATERIAL FOR USE WITH A SURGICAL STAPLE CARTRIDGE AND SURGICAL STAPLE CARTRIDGE FOR USE WITH A SURGICAL INSTRUMENT |
US10076325B2 (en) | 2014-10-13 | 2018-09-18 | Ethicon Llc | Surgical stapling apparatus comprising a tissue stop |
US9924944B2 (en) | 2014-10-16 | 2018-03-27 | Ethicon Llc | Staple cartridge comprising an adjunct material |
US11141153B2 (en) | 2014-10-29 | 2021-10-12 | Cilag Gmbh International | Staple cartridges comprising driver arrangements |
US10517594B2 (en) | 2014-10-29 | 2019-12-31 | Ethicon Llc | Cartridge assemblies for surgical staplers |
US9844376B2 (en) | 2014-11-06 | 2017-12-19 | Ethicon Llc | Staple cartridge comprising a releasable adjunct material |
US10736636B2 (en) | 2014-12-10 | 2020-08-11 | Ethicon Llc | Articulatable surgical instrument system |
BR112017012996B1 (en) | 2014-12-18 | 2022-11-08 | Ethicon Llc | SURGICAL INSTRUMENT WITH AN ANvil WHICH IS SELECTIVELY MOVABLE ABOUT AN IMMOVABLE GEOMETRIC AXIS DIFFERENT FROM A STAPLE CARTRIDGE |
US9844374B2 (en) | 2014-12-18 | 2017-12-19 | Ethicon Llc | Surgical instrument systems comprising an articulatable end effector and means for adjusting the firing stroke of a firing member |
US10117649B2 (en) | 2014-12-18 | 2018-11-06 | Ethicon Llc | Surgical instrument assembly comprising a lockable articulation system |
US10188385B2 (en) | 2014-12-18 | 2019-01-29 | Ethicon Llc | Surgical instrument system comprising lockable systems |
US9844375B2 (en) | 2014-12-18 | 2017-12-19 | Ethicon Llc | Drive arrangements for articulatable surgical instruments |
US9987000B2 (en) | 2014-12-18 | 2018-06-05 | Ethicon Llc | Surgical instrument assembly comprising a flexible articulation system |
US10004501B2 (en) | 2014-12-18 | 2018-06-26 | Ethicon Llc | Surgical instruments with improved closure arrangements |
US10085748B2 (en) | 2014-12-18 | 2018-10-02 | Ethicon Llc | Locking arrangements for detachable shaft assemblies with articulatable surgical end effectors |
US10180463B2 (en) | 2015-02-27 | 2019-01-15 | Ethicon Llc | Surgical apparatus configured to assess whether a performance parameter of the surgical apparatus is within an acceptable performance band |
US9993258B2 (en) | 2015-02-27 | 2018-06-12 | Ethicon Llc | Adaptable surgical instrument handle |
US9931118B2 (en) | 2015-02-27 | 2018-04-03 | Ethicon Endo-Surgery, Llc | Reinforced battery for a surgical instrument |
US11154301B2 (en) | 2015-02-27 | 2021-10-26 | Cilag Gmbh International | Modular stapling assembly |
US9808246B2 (en) | 2015-03-06 | 2017-11-07 | Ethicon Endo-Surgery, Llc | Method of operating a powered surgical instrument |
US10548504B2 (en) | 2015-03-06 | 2020-02-04 | Ethicon Llc | Overlaid multi sensor radio frequency (RF) electrode system to measure tissue compression |
US10045776B2 (en) | 2015-03-06 | 2018-08-14 | Ethicon Llc | Control techniques and sub-processor contained within modular shaft with select control processing from handle |
US10441279B2 (en) | 2015-03-06 | 2019-10-15 | Ethicon Llc | Multiple level thresholds to modify operation of powered surgical instruments |
US9993248B2 (en) | 2015-03-06 | 2018-06-12 | Ethicon Endo-Surgery, Llc | Smart sensors with local signal processing |
US9924961B2 (en) | 2015-03-06 | 2018-03-27 | Ethicon Endo-Surgery, Llc | Interactive feedback system for powered surgical instruments |
JP2020121162A (en) | 2015-03-06 | 2020-08-13 | エシコン エルエルシーEthicon LLC | Time dependent evaluation of sensor data to determine stability element, creep element and viscoelastic element of measurement |
US9895148B2 (en) | 2015-03-06 | 2018-02-20 | Ethicon Endo-Surgery, Llc | Monitoring speed control and precision incrementing of motor for powered surgical instruments |
US10687806B2 (en) | 2015-03-06 | 2020-06-23 | Ethicon Llc | Adaptive tissue compression techniques to adjust closure rates for multiple tissue types |
US9901342B2 (en) | 2015-03-06 | 2018-02-27 | Ethicon Endo-Surgery, Llc | Signal and power communication system positioned on a rotatable shaft |
US10245033B2 (en) | 2015-03-06 | 2019-04-02 | Ethicon Llc | Surgical instrument comprising a lockable battery housing |
US10617412B2 (en) | 2015-03-06 | 2020-04-14 | Ethicon Llc | System for detecting the mis-insertion of a staple cartridge into a surgical stapler |
US10433844B2 (en) | 2015-03-31 | 2019-10-08 | Ethicon Llc | Surgical instrument with selectively disengageable threaded drive systems |
US10052102B2 (en) | 2015-06-18 | 2018-08-21 | Ethicon Llc | Surgical end effectors with dual cam actuated jaw closing features |
US10835249B2 (en) | 2015-08-17 | 2020-11-17 | Ethicon Llc | Implantable layers for a surgical instrument |
US10098642B2 (en) | 2015-08-26 | 2018-10-16 | Ethicon Llc | Surgical staples comprising features for improved fastening of tissue |
MX2022009705A (en) | 2015-08-26 | 2022-11-07 | Ethicon Llc | Surgical staples comprising hardness variations for improved fastening of tissue. |
BR112018003693B1 (en) | 2015-08-26 | 2022-11-22 | Ethicon Llc | SURGICAL STAPLE CARTRIDGE FOR USE WITH A SURGICAL STAPPING INSTRUMENT |
US10172619B2 (en) | 2015-09-02 | 2019-01-08 | Ethicon Llc | Surgical staple driver arrays |
MX2022006189A (en) | 2015-09-02 | 2022-06-16 | Ethicon Llc | Surgical staple configurations with camming surfaces located between portions supporting surgical staples. |
US10076326B2 (en) | 2015-09-23 | 2018-09-18 | Ethicon Llc | Surgical stapler having current mirror-based motor control |
US10085751B2 (en) | 2015-09-23 | 2018-10-02 | Ethicon Llc | Surgical stapler having temperature-based motor control |
US10238386B2 (en) | 2015-09-23 | 2019-03-26 | Ethicon Llc | Surgical stapler having motor control based on an electrical parameter related to a motor current |
US10327769B2 (en) | 2015-09-23 | 2019-06-25 | Ethicon Llc | Surgical stapler having motor control based on a drive system component |
US10363036B2 (en) | 2015-09-23 | 2019-07-30 | Ethicon Llc | Surgical stapler having force-based motor control |
US10105139B2 (en) | 2015-09-23 | 2018-10-23 | Ethicon Llc | Surgical stapler having downstream current-based motor control |
US10299878B2 (en) | 2015-09-25 | 2019-05-28 | Ethicon Llc | Implantable adjunct systems for determining adjunct skew |
US10980539B2 (en) | 2015-09-30 | 2021-04-20 | Ethicon Llc | Implantable adjunct comprising bonded layers |
US10271849B2 (en) | 2015-09-30 | 2019-04-30 | Ethicon Llc | Woven constructs with interlocked standing fibers |
US11890015B2 (en) | 2015-09-30 | 2024-02-06 | Cilag Gmbh International | Compressible adjunct with crossing spacer fibers |
US10172620B2 (en) | 2015-09-30 | 2019-01-08 | Ethicon Llc | Compressible adjuncts with bonding nodes |
US10292704B2 (en) | 2015-12-30 | 2019-05-21 | Ethicon Llc | Mechanisms for compensating for battery pack failure in powered surgical instruments |
US10368865B2 (en) | 2015-12-30 | 2019-08-06 | Ethicon Llc | Mechanisms for compensating for drivetrain failure in powered surgical instruments |
US10265068B2 (en) | 2015-12-30 | 2019-04-23 | Ethicon Llc | Surgical instruments with separable motors and motor control circuits |
US11213293B2 (en) | 2016-02-09 | 2022-01-04 | Cilag Gmbh International | Articulatable surgical instruments with single articulation link arrangements |
JP6911054B2 (en) | 2016-02-09 | 2021-07-28 | エシコン エルエルシーEthicon LLC | Surgical instruments with asymmetric joint composition |
US10245030B2 (en) | 2016-02-09 | 2019-04-02 | Ethicon Llc | Surgical instruments with tensioning arrangements for cable driven articulation systems |
US10448948B2 (en) | 2016-02-12 | 2019-10-22 | Ethicon Llc | Mechanisms for compensating for drivetrain failure in powered surgical instruments |
US11224426B2 (en) | 2016-02-12 | 2022-01-18 | Cilag Gmbh International | Mechanisms for compensating for drivetrain failure in powered surgical instruments |
US10258331B2 (en) | 2016-02-12 | 2019-04-16 | Ethicon Llc | Mechanisms for compensating for drivetrain failure in powered surgical instruments |
US10285705B2 (en) | 2016-04-01 | 2019-05-14 | Ethicon Llc | Surgical stapling system comprising a grooved forming pocket |
US10617413B2 (en) | 2016-04-01 | 2020-04-14 | Ethicon Llc | Closure system arrangements for surgical cutting and stapling devices with separate and distinct firing shafts |
US10307159B2 (en) | 2016-04-01 | 2019-06-04 | Ethicon Llc | Surgical instrument handle assembly with reconfigurable grip portion |
US11284890B2 (en) | 2016-04-01 | 2022-03-29 | Cilag Gmbh International | Circular stapling system comprising an incisable tissue support |
US10682136B2 (en) | 2016-04-01 | 2020-06-16 | Ethicon Llc | Circular stapling system comprising load control |
US10828028B2 (en) | 2016-04-15 | 2020-11-10 | Ethicon Llc | Surgical instrument with multiple program responses during a firing motion |
US10492783B2 (en) | 2016-04-15 | 2019-12-03 | Ethicon, Llc | Surgical instrument with improved stop/start control during a firing motion |
US10456137B2 (en) | 2016-04-15 | 2019-10-29 | Ethicon Llc | Staple formation detection mechanisms |
US10357247B2 (en) | 2016-04-15 | 2019-07-23 | Ethicon Llc | Surgical instrument with multiple program responses during a firing motion |
US11179150B2 (en) | 2016-04-15 | 2021-11-23 | Cilag Gmbh International | Systems and methods for controlling a surgical stapling and cutting instrument |
US11607239B2 (en) | 2016-04-15 | 2023-03-21 | Cilag Gmbh International | Systems and methods for controlling a surgical stapling and cutting instrument |
US10426467B2 (en) | 2016-04-15 | 2019-10-01 | Ethicon Llc | Surgical instrument with detection sensors |
US10335145B2 (en) | 2016-04-15 | 2019-07-02 | Ethicon Llc | Modular surgical instrument with configurable operating mode |
US10405859B2 (en) | 2016-04-15 | 2019-09-10 | Ethicon Llc | Surgical instrument with adjustable stop/start control during a firing motion |
US10368867B2 (en) | 2016-04-18 | 2019-08-06 | Ethicon Llc | Surgical instrument comprising a lockout |
US20170296173A1 (en) | 2016-04-18 | 2017-10-19 | Ethicon Endo-Surgery, Llc | Method for operating a surgical instrument |
US11317917B2 (en) | 2016-04-18 | 2022-05-03 | Cilag Gmbh International | Surgical stapling system comprising a lockable firing assembly |
JP6957532B2 (en) | 2016-06-24 | 2021-11-02 | エシコン エルエルシーEthicon LLC | Staple cartridges including wire staples and punched staples |
US10702270B2 (en) | 2016-06-24 | 2020-07-07 | Ethicon Llc | Stapling system for use with wire staples and stamped staples |
USD850617S1 (en) | 2016-06-24 | 2019-06-04 | Ethicon Llc | Surgical fastener cartridge |
USD826405S1 (en) | 2016-06-24 | 2018-08-21 | Ethicon Llc | Surgical fastener |
USD847989S1 (en) | 2016-06-24 | 2019-05-07 | Ethicon Llc | Surgical fastener cartridge |
US10881401B2 (en) | 2016-12-21 | 2021-01-05 | Ethicon Llc | Staple firing member comprising a missing cartridge and/or spent cartridge lockout |
US11179155B2 (en) | 2016-12-21 | 2021-11-23 | Cilag Gmbh International | Anvil arrangements for surgical staplers |
US10687810B2 (en) | 2016-12-21 | 2020-06-23 | Ethicon Llc | Stepped staple cartridge with tissue retention and gap setting features |
JP6983893B2 (en) | 2016-12-21 | 2021-12-17 | エシコン エルエルシーEthicon LLC | Lockout configuration for surgical end effectors and replaceable tool assemblies |
US10426471B2 (en) | 2016-12-21 | 2019-10-01 | Ethicon Llc | Surgical instrument with multiple failure response modes |
US10485543B2 (en) | 2016-12-21 | 2019-11-26 | Ethicon Llc | Anvil having a knife slot width |
US20180168615A1 (en) | 2016-12-21 | 2018-06-21 | Ethicon Endo-Surgery, Llc | Method of deforming staples from two different types of staple cartridges with the same surgical stapling instrument |
US11134942B2 (en) | 2016-12-21 | 2021-10-05 | Cilag Gmbh International | Surgical stapling instruments and staple-forming anvils |
MX2019007295A (en) | 2016-12-21 | 2019-10-15 | Ethicon Llc | Surgical instrument system comprising an end effector lockout and a firing assembly lockout. |
MX2019007311A (en) | 2016-12-21 | 2019-11-18 | Ethicon Llc | Surgical stapling systems. |
US20180168575A1 (en) | 2016-12-21 | 2018-06-21 | Ethicon Endo-Surgery, Llc | Surgical stapling systems |
US20180168647A1 (en) | 2016-12-21 | 2018-06-21 | Ethicon Endo-Surgery, Llc | Surgical stapling instruments having end effectors with positive opening features |
US11090048B2 (en) | 2016-12-21 | 2021-08-17 | Cilag Gmbh International | Method for resetting a fuse of a surgical instrument shaft |
US10682138B2 (en) | 2016-12-21 | 2020-06-16 | Ethicon Llc | Bilaterally asymmetric staple forming pocket pairs |
US11419606B2 (en) | 2016-12-21 | 2022-08-23 | Cilag Gmbh International | Shaft assembly comprising a clutch configured to adapt the output of a rotary firing member to two different systems |
US20180168633A1 (en) | 2016-12-21 | 2018-06-21 | Ethicon Endo-Surgery, Llc | Surgical stapling instruments and staple-forming anvils |
US20180168609A1 (en) | 2016-12-21 | 2018-06-21 | Ethicon Endo-Surgery, Llc | Firing assembly comprising a fuse |
US10945727B2 (en) | 2016-12-21 | 2021-03-16 | Ethicon Llc | Staple cartridge with deformable driver retention features |
US10624635B2 (en) | 2016-12-21 | 2020-04-21 | Ethicon Llc | Firing members with non-parallel jaw engagement features for surgical end effectors |
US20180168625A1 (en) | 2016-12-21 | 2018-06-21 | Ethicon Endo-Surgery, Llc | Surgical stapling instruments with smart staple cartridges |
US10993715B2 (en) | 2016-12-21 | 2021-05-04 | Ethicon Llc | Staple cartridge comprising staples with different clamping breadths |
US10835247B2 (en) | 2016-12-21 | 2020-11-17 | Ethicon Llc | Lockout arrangements for surgical end effectors |
US11684367B2 (en) | 2016-12-21 | 2023-06-27 | Cilag Gmbh International | Stepped assembly having and end-of-life indicator |
JP7010956B2 (en) | 2016-12-21 | 2022-01-26 | エシコン エルエルシー | How to staple tissue |
US10675025B2 (en) | 2016-12-21 | 2020-06-09 | Ethicon Llc | Shaft assembly comprising separately actuatable and retractable systems |
US10813639B2 (en) | 2017-06-20 | 2020-10-27 | Ethicon Llc | Closed loop feedback control of motor velocity of a surgical stapling and cutting instrument based on system conditions |
US10646220B2 (en) | 2017-06-20 | 2020-05-12 | Ethicon Llc | Systems and methods for controlling displacement member velocity for a surgical instrument |
US10779820B2 (en) | 2017-06-20 | 2020-09-22 | Ethicon Llc | Systems and methods for controlling motor speed according to user input for a surgical instrument |
US10980537B2 (en) | 2017-06-20 | 2021-04-20 | Ethicon Llc | Closed loop feedback control of motor velocity of a surgical stapling and cutting instrument based on measured time over a specified number of shaft rotations |
US11071554B2 (en) | 2017-06-20 | 2021-07-27 | Cilag Gmbh International | Closed loop feedback control of motor velocity of a surgical stapling and cutting instrument based on magnitude of velocity error measurements |
US10390841B2 (en) | 2017-06-20 | 2019-08-27 | Ethicon Llc | Control of motor velocity of a surgical stapling and cutting instrument based on angle of articulation |
US10307170B2 (en) | 2017-06-20 | 2019-06-04 | Ethicon Llc | Method for closed loop control of motor velocity of a surgical stapling and cutting instrument |
US11517325B2 (en) | 2017-06-20 | 2022-12-06 | Cilag Gmbh International | Closed loop feedback control of motor velocity of a surgical stapling and cutting instrument based on measured displacement distance traveled over a specified time interval |
US10327767B2 (en) | 2017-06-20 | 2019-06-25 | Ethicon Llc | Control of motor velocity of a surgical stapling and cutting instrument based on angle of articulation |
US11090046B2 (en) | 2017-06-20 | 2021-08-17 | Cilag Gmbh International | Systems and methods for controlling displacement member motion of a surgical stapling and cutting instrument |
US10888321B2 (en) | 2017-06-20 | 2021-01-12 | Ethicon Llc | Systems and methods for controlling velocity of a displacement member of a surgical stapling and cutting instrument |
USD879809S1 (en) | 2017-06-20 | 2020-03-31 | Ethicon Llc | Display panel with changeable graphical user interface |
US11382638B2 (en) | 2017-06-20 | 2022-07-12 | Cilag Gmbh International | Closed loop feedback control of motor velocity of a surgical stapling and cutting instrument based on measured time over a specified displacement distance |
US10881399B2 (en) | 2017-06-20 | 2021-01-05 | Ethicon Llc | Techniques for adaptive control of motor velocity of a surgical stapling and cutting instrument |
US10881396B2 (en) | 2017-06-20 | 2021-01-05 | Ethicon Llc | Surgical instrument with variable duration trigger arrangement |
US10624633B2 (en) | 2017-06-20 | 2020-04-21 | Ethicon Llc | Systems and methods for controlling motor velocity of a surgical stapling and cutting instrument |
US10368864B2 (en) | 2017-06-20 | 2019-08-06 | Ethicon Llc | Systems and methods for controlling displaying motor velocity for a surgical instrument |
US11653914B2 (en) | 2017-06-20 | 2023-05-23 | Cilag Gmbh International | Systems and methods for controlling motor velocity of a surgical stapling and cutting instrument according to articulation angle of end effector |
USD879808S1 (en) | 2017-06-20 | 2020-03-31 | Ethicon Llc | Display panel with graphical user interface |
USD890784S1 (en) | 2017-06-20 | 2020-07-21 | Ethicon Llc | Display panel with changeable graphical user interface |
US11266405B2 (en) | 2017-06-27 | 2022-03-08 | Cilag Gmbh International | Surgical anvil manufacturing methods |
US11141154B2 (en) | 2017-06-27 | 2021-10-12 | Cilag Gmbh International | Surgical end effectors and anvils |
US11324503B2 (en) | 2017-06-27 | 2022-05-10 | Cilag Gmbh International | Surgical firing member arrangements |
US10856869B2 (en) | 2017-06-27 | 2020-12-08 | Ethicon Llc | Surgical anvil arrangements |
US10772629B2 (en) | 2017-06-27 | 2020-09-15 | Ethicon Llc | Surgical anvil arrangements |
US10993716B2 (en) | 2017-06-27 | 2021-05-04 | Ethicon Llc | Surgical anvil arrangements |
EP3420947B1 (en) | 2017-06-28 | 2022-05-25 | Cilag GmbH International | Surgical instrument comprising selectively actuatable rotatable couplers |
USD906355S1 (en) | 2017-06-28 | 2020-12-29 | Ethicon Llc | Display screen or portion thereof with a graphical user interface for a surgical instrument |
US11678880B2 (en) | 2017-06-28 | 2023-06-20 | Cilag Gmbh International | Surgical instrument comprising a shaft including a housing arrangement |
US11246592B2 (en) | 2017-06-28 | 2022-02-15 | Cilag Gmbh International | Surgical instrument comprising an articulation system lockable to a frame |
US20190000459A1 (en) | 2017-06-28 | 2019-01-03 | Ethicon Llc | Surgical instruments with jaws constrained to pivot about an axis upon contact with a closure member that is parked in close proximity to the pivot axis |
US11564686B2 (en) | 2017-06-28 | 2023-01-31 | Cilag Gmbh International | Surgical shaft assemblies with flexible interfaces |
USD854151S1 (en) | 2017-06-28 | 2019-07-16 | Ethicon Llc | Surgical instrument shaft |
US10716614B2 (en) | 2017-06-28 | 2020-07-21 | Ethicon Llc | Surgical shaft assemblies with slip ring assemblies with increased contact pressure |
US10903685B2 (en) | 2017-06-28 | 2021-01-26 | Ethicon Llc | Surgical shaft assemblies with slip ring assemblies forming capacitive channels |
USD851762S1 (en) | 2017-06-28 | 2019-06-18 | Ethicon Llc | Anvil |
US10765427B2 (en) | 2017-06-28 | 2020-09-08 | Ethicon Llc | Method for articulating a surgical instrument |
US11259805B2 (en) | 2017-06-28 | 2022-03-01 | Cilag Gmbh International | Surgical instrument comprising firing member supports |
US10211586B2 (en) | 2017-06-28 | 2019-02-19 | Ethicon Llc | Surgical shaft assemblies with watertight housings |
US10898183B2 (en) | 2017-06-29 | 2021-01-26 | Ethicon Llc | Robotic surgical instrument with closed loop feedback techniques for advancement of closure member during firing |
US11007022B2 (en) | 2017-06-29 | 2021-05-18 | Ethicon Llc | Closed loop velocity control techniques based on sensed tissue parameters for robotic surgical instrument |
US10398434B2 (en) | 2017-06-29 | 2019-09-03 | Ethicon Llc | Closed loop velocity control of closure member for robotic surgical instrument |
US10258418B2 (en) | 2017-06-29 | 2019-04-16 | Ethicon Llc | System for controlling articulation forces |
US10932772B2 (en) | 2017-06-29 | 2021-03-02 | Ethicon Llc | Methods for closed loop velocity control for robotic surgical instrument |
US11471155B2 (en) | 2017-08-03 | 2022-10-18 | Cilag Gmbh International | Surgical system bailout |
US11944300B2 (en) | 2017-08-03 | 2024-04-02 | Cilag Gmbh International | Method for operating a surgical system bailout |
US11304695B2 (en) | 2017-08-03 | 2022-04-19 | Cilag Gmbh International | Surgical system shaft interconnection |
US11974742B2 (en) | 2017-08-03 | 2024-05-07 | Cilag Gmbh International | Surgical system comprising an articulation bailout |
US10729501B2 (en) | 2017-09-29 | 2020-08-04 | Ethicon Llc | Systems and methods for language selection of a surgical instrument |
USD917500S1 (en) | 2017-09-29 | 2021-04-27 | Ethicon Llc | Display screen or portion thereof with graphical user interface |
USD907647S1 (en) | 2017-09-29 | 2021-01-12 | Ethicon Llc | Display screen or portion thereof with animated graphical user interface |
US10765429B2 (en) | 2017-09-29 | 2020-09-08 | Ethicon Llc | Systems and methods for providing alerts according to the operational state of a surgical instrument |
US10796471B2 (en) | 2017-09-29 | 2020-10-06 | Ethicon Llc | Systems and methods of displaying a knife position for a surgical instrument |
US11399829B2 (en) | 2017-09-29 | 2022-08-02 | Cilag Gmbh International | Systems and methods of initiating a power shutdown mode for a surgical instrument |
USD907648S1 (en) | 2017-09-29 | 2021-01-12 | Ethicon Llc | Display screen or portion thereof with animated graphical user interface |
US10743872B2 (en) | 2017-09-29 | 2020-08-18 | Ethicon Llc | System and methods for controlling a display of a surgical instrument |
US11090075B2 (en) | 2017-10-30 | 2021-08-17 | Cilag Gmbh International | Articulation features for surgical end effector |
US11134944B2 (en) | 2017-10-30 | 2021-10-05 | Cilag Gmbh International | Surgical stapler knife motion controls |
US10779903B2 (en) | 2017-10-31 | 2020-09-22 | Ethicon Llc | Positive shaft rotation lock activated by jaw closure |
US10842490B2 (en) | 2017-10-31 | 2020-11-24 | Ethicon Llc | Cartridge body design with force reduction based on firing completion |
US10779825B2 (en) | 2017-12-15 | 2020-09-22 | Ethicon Llc | Adapters with end effector position sensing and control arrangements for use in connection with electromechanical surgical instruments |
US10743874B2 (en) | 2017-12-15 | 2020-08-18 | Ethicon Llc | Sealed adapters for use with electromechanical surgical instruments |
US10828033B2 (en) | 2017-12-15 | 2020-11-10 | Ethicon Llc | Handheld electromechanical surgical instruments with improved motor control arrangements for positioning components of an adapter coupled thereto |
US11197670B2 (en) | 2017-12-15 | 2021-12-14 | Cilag Gmbh International | Surgical end effectors with pivotal jaws configured to touch at their respective distal ends when fully closed |
US10743875B2 (en) | 2017-12-15 | 2020-08-18 | Ethicon Llc | Surgical end effectors with jaw stiffener arrangements configured to permit monitoring of firing member |
US10966718B2 (en) | 2017-12-15 | 2021-04-06 | Ethicon Llc | Dynamic clamping assemblies with improved wear characteristics for use in connection with electromechanical surgical instruments |
US10869666B2 (en) | 2017-12-15 | 2020-12-22 | Ethicon Llc | Adapters with control systems for controlling multiple motors of an electromechanical surgical instrument |
US11033267B2 (en) | 2017-12-15 | 2021-06-15 | Ethicon Llc | Systems and methods of controlling a clamping member firing rate of a surgical instrument |
US11006955B2 (en) | 2017-12-15 | 2021-05-18 | Ethicon Llc | End effectors with positive jaw opening features for use with adapters for electromechanical surgical instruments |
US10779826B2 (en) | 2017-12-15 | 2020-09-22 | Ethicon Llc | Methods of operating surgical end effectors |
US10687813B2 (en) | 2017-12-15 | 2020-06-23 | Ethicon Llc | Adapters with firing stroke sensing arrangements for use in connection with electromechanical surgical instruments |
US11071543B2 (en) | 2017-12-15 | 2021-07-27 | Cilag Gmbh International | Surgical end effectors with clamping assemblies configured to increase jaw aperture ranges |
USD910847S1 (en) | 2017-12-19 | 2021-02-16 | Ethicon Llc | Surgical instrument assembly |
US10716565B2 (en) | 2017-12-19 | 2020-07-21 | Ethicon Llc | Surgical instruments with dual articulation drivers |
US11045270B2 (en) | 2017-12-19 | 2021-06-29 | Cilag Gmbh International | Robotic attachment comprising exterior drive actuator |
US11020112B2 (en) | 2017-12-19 | 2021-06-01 | Ethicon Llc | Surgical tools configured for interchangeable use with different controller interfaces |
US10835330B2 (en) | 2017-12-19 | 2020-11-17 | Ethicon Llc | Method for determining the position of a rotatable jaw of a surgical instrument attachment assembly |
US10729509B2 (en) | 2017-12-19 | 2020-08-04 | Ethicon Llc | Surgical instrument comprising closure and firing locking mechanism |
US11311290B2 (en) | 2017-12-21 | 2022-04-26 | Cilag Gmbh International | Surgical instrument comprising an end effector dampener |
US11076853B2 (en) | 2017-12-21 | 2021-08-03 | Cilag Gmbh International | Systems and methods of displaying a knife position during transection for a surgical instrument |
US11129680B2 (en) | 2017-12-21 | 2021-09-28 | Cilag Gmbh International | Surgical instrument comprising a projector |
US11179152B2 (en) | 2017-12-21 | 2021-11-23 | Cilag Gmbh International | Surgical instrument comprising a tissue grasping system |
USD914878S1 (en) | 2018-08-20 | 2021-03-30 | Ethicon Llc | Surgical instrument anvil |
US10779821B2 (en) | 2018-08-20 | 2020-09-22 | Ethicon Llc | Surgical stapler anvils with tissue stop features configured to avoid tissue pinch |
US10856870B2 (en) | 2018-08-20 | 2020-12-08 | Ethicon Llc | Switching arrangements for motor powered articulatable surgical instruments |
US11253256B2 (en) | 2018-08-20 | 2022-02-22 | Cilag Gmbh International | Articulatable motor powered surgical instruments with dedicated articulation motor arrangements |
US11324501B2 (en) | 2018-08-20 | 2022-05-10 | Cilag Gmbh International | Surgical stapling devices with improved closure members |
US10842492B2 (en) | 2018-08-20 | 2020-11-24 | Ethicon Llc | Powered articulatable surgical instruments with clutching and locking arrangements for linking an articulation drive system to a firing drive system |
US11039834B2 (en) | 2018-08-20 | 2021-06-22 | Cilag Gmbh International | Surgical stapler anvils with staple directing protrusions and tissue stability features |
US11291440B2 (en) | 2018-08-20 | 2022-04-05 | Cilag Gmbh International | Method for operating a powered articulatable surgical instrument |
US10912559B2 (en) | 2018-08-20 | 2021-02-09 | Ethicon Llc | Reinforced deformable anvil tip for surgical stapler anvil |
US11083458B2 (en) | 2018-08-20 | 2021-08-10 | Cilag Gmbh International | Powered surgical instruments with clutching arrangements to convert linear drive motions to rotary drive motions |
US11207065B2 (en) | 2018-08-20 | 2021-12-28 | Cilag Gmbh International | Method for fabricating surgical stapler anvils |
US11045192B2 (en) | 2018-08-20 | 2021-06-29 | Cilag Gmbh International | Fabricating techniques for surgical stapler anvils |
US11147551B2 (en) | 2019-03-25 | 2021-10-19 | Cilag Gmbh International | Firing drive arrangements for surgical systems |
US11147553B2 (en) | 2019-03-25 | 2021-10-19 | Cilag Gmbh International | Firing drive arrangements for surgical systems |
US11696761B2 (en) | 2019-03-25 | 2023-07-11 | Cilag Gmbh International | Firing drive arrangements for surgical systems |
US11172929B2 (en) | 2019-03-25 | 2021-11-16 | Cilag Gmbh International | Articulation drive arrangements for surgical systems |
US11452528B2 (en) | 2019-04-30 | 2022-09-27 | Cilag Gmbh International | Articulation actuators for a surgical instrument |
US11432816B2 (en) | 2019-04-30 | 2022-09-06 | Cilag Gmbh International | Articulation pin for a surgical instrument |
US11903581B2 (en) | 2019-04-30 | 2024-02-20 | Cilag Gmbh International | Methods for stapling tissue using a surgical instrument |
US11426251B2 (en) | 2019-04-30 | 2022-08-30 | Cilag Gmbh International | Articulation directional lights on a surgical instrument |
US11648009B2 (en) | 2019-04-30 | 2023-05-16 | Cilag Gmbh International | Rotatable jaw tip for a surgical instrument |
US11471157B2 (en) | 2019-04-30 | 2022-10-18 | Cilag Gmbh International | Articulation control mapping for a surgical instrument |
US11253254B2 (en) | 2019-04-30 | 2022-02-22 | Cilag Gmbh International | Shaft rotation actuator on a surgical instrument |
US11627959B2 (en) | 2019-06-28 | 2023-04-18 | Cilag Gmbh International | Surgical instruments including manual and powered system lockouts |
US11219455B2 (en) | 2019-06-28 | 2022-01-11 | Cilag Gmbh International | Surgical instrument including a lockout key |
US12004740B2 (en) | 2019-06-28 | 2024-06-11 | Cilag Gmbh International | Surgical stapling system having an information decryption protocol |
US11478241B2 (en) | 2019-06-28 | 2022-10-25 | Cilag Gmbh International | Staple cartridge including projections |
US11298127B2 (en) | 2019-06-28 | 2022-04-12 | Cilag GmbH Interational | Surgical stapling system having a lockout mechanism for an incompatible cartridge |
US11246678B2 (en) | 2019-06-28 | 2022-02-15 | Cilag Gmbh International | Surgical stapling system having a frangible RFID tag |
US11291451B2 (en) | 2019-06-28 | 2022-04-05 | Cilag Gmbh International | Surgical instrument with battery compatibility verification functionality |
US11497492B2 (en) | 2019-06-28 | 2022-11-15 | Cilag Gmbh International | Surgical instrument including an articulation lock |
US11553971B2 (en) | 2019-06-28 | 2023-01-17 | Cilag Gmbh International | Surgical RFID assemblies for display and communication |
US11638587B2 (en) | 2019-06-28 | 2023-05-02 | Cilag Gmbh International | RFID identification systems for surgical instruments |
US11684434B2 (en) | 2019-06-28 | 2023-06-27 | Cilag Gmbh International | Surgical RFID assemblies for instrument operational setting control |
US11426167B2 (en) | 2019-06-28 | 2022-08-30 | Cilag Gmbh International | Mechanisms for proper anvil attachment surgical stapling head assembly |
US11350938B2 (en) | 2019-06-28 | 2022-06-07 | Cilag Gmbh International | Surgical instrument comprising an aligned rfid sensor |
US11399837B2 (en) | 2019-06-28 | 2022-08-02 | Cilag Gmbh International | Mechanisms for motor control adjustments of a motorized surgical instrument |
US11464601B2 (en) | 2019-06-28 | 2022-10-11 | Cilag Gmbh International | Surgical instrument comprising an RFID system for tracking a movable component |
US11224497B2 (en) | 2019-06-28 | 2022-01-18 | Cilag Gmbh International | Surgical systems with multiple RFID tags |
US11771419B2 (en) | 2019-06-28 | 2023-10-03 | Cilag Gmbh International | Packaging for a replaceable component of a surgical stapling system |
US11376098B2 (en) | 2019-06-28 | 2022-07-05 | Cilag Gmbh International | Surgical instrument system comprising an RFID system |
US11051807B2 (en) | 2019-06-28 | 2021-07-06 | Cilag Gmbh International | Packaging assembly including a particulate trap |
US11660163B2 (en) | 2019-06-28 | 2023-05-30 | Cilag Gmbh International | Surgical system with RFID tags for updating motor assembly parameters |
US11523822B2 (en) | 2019-06-28 | 2022-12-13 | Cilag Gmbh International | Battery pack including a circuit interrupter |
US11259803B2 (en) | 2019-06-28 | 2022-03-01 | Cilag Gmbh International | Surgical stapling system having an information encryption protocol |
US11298132B2 (en) | 2019-06-28 | 2022-04-12 | Cilag GmbH Inlernational | Staple cartridge including a honeycomb extension |
US12035913B2 (en) | 2019-12-19 | 2024-07-16 | Cilag Gmbh International | Staple cartridge comprising a deployable knife |
US11464512B2 (en) | 2019-12-19 | 2022-10-11 | Cilag Gmbh International | Staple cartridge comprising a curved deck surface |
US11304696B2 (en) | 2019-12-19 | 2022-04-19 | Cilag Gmbh International | Surgical instrument comprising a powered articulation system |
US11529139B2 (en) | 2019-12-19 | 2022-12-20 | Cilag Gmbh International | Motor driven surgical instrument |
US11559304B2 (en) | 2019-12-19 | 2023-01-24 | Cilag Gmbh International | Surgical instrument comprising a rapid closure mechanism |
US11446029B2 (en) | 2019-12-19 | 2022-09-20 | Cilag Gmbh International | Staple cartridge comprising projections extending from a curved deck surface |
US11911032B2 (en) | 2019-12-19 | 2024-02-27 | Cilag Gmbh International | Staple cartridge comprising a seating cam |
US11291447B2 (en) | 2019-12-19 | 2022-04-05 | Cilag Gmbh International | Stapling instrument comprising independent jaw closing and staple firing systems |
US11607219B2 (en) | 2019-12-19 | 2023-03-21 | Cilag Gmbh International | Staple cartridge comprising a detachable tissue cutting knife |
US11576672B2 (en) | 2019-12-19 | 2023-02-14 | Cilag Gmbh International | Surgical instrument comprising a closure system including a closure member and an opening member driven by a drive screw |
US11844520B2 (en) | 2019-12-19 | 2023-12-19 | Cilag Gmbh International | Staple cartridge comprising driver retention members |
US11931033B2 (en) | 2019-12-19 | 2024-03-19 | Cilag Gmbh International | Staple cartridge comprising a latch lockout |
US11701111B2 (en) | 2019-12-19 | 2023-07-18 | Cilag Gmbh International | Method for operating a surgical stapling instrument |
US11504122B2 (en) | 2019-12-19 | 2022-11-22 | Cilag Gmbh International | Surgical instrument comprising a nested firing member |
US11234698B2 (en) | 2019-12-19 | 2022-02-01 | Cilag Gmbh International | Stapling system comprising a clamp lockout and a firing lockout |
US11529137B2 (en) | 2019-12-19 | 2022-12-20 | Cilag Gmbh International | Staple cartridge comprising driver retention members |
US20210361340A1 (en) * | 2020-05-21 | 2021-11-25 | Covidien Lp | Independent control of dual rf electrosurgery |
US20210361339A1 (en) * | 2020-05-21 | 2021-11-25 | Covidien Lp | Independent control of dual rf monopolar electrosurgery with shared return electrode |
USD975278S1 (en) | 2020-06-02 | 2023-01-10 | Cilag Gmbh International | Staple cartridge |
USD975850S1 (en) | 2020-06-02 | 2023-01-17 | Cilag Gmbh International | Staple cartridge |
USD975851S1 (en) | 2020-06-02 | 2023-01-17 | Cilag Gmbh International | Staple cartridge |
USD966512S1 (en) | 2020-06-02 | 2022-10-11 | Cilag Gmbh International | Staple cartridge |
USD976401S1 (en) | 2020-06-02 | 2023-01-24 | Cilag Gmbh International | Staple cartridge |
USD974560S1 (en) | 2020-06-02 | 2023-01-03 | Cilag Gmbh International | Staple cartridge |
USD967421S1 (en) | 2020-06-02 | 2022-10-18 | Cilag Gmbh International | Staple cartridge |
US11737748B2 (en) | 2020-07-28 | 2023-08-29 | Cilag Gmbh International | Surgical instruments with double spherical articulation joints with pivotable links |
USD980425S1 (en) | 2020-10-29 | 2023-03-07 | Cilag Gmbh International | Surgical instrument assembly |
US11844518B2 (en) | 2020-10-29 | 2023-12-19 | Cilag Gmbh International | Method for operating a surgical instrument |
US11896217B2 (en) | 2020-10-29 | 2024-02-13 | Cilag Gmbh International | Surgical instrument comprising an articulation lock |
US11617577B2 (en) | 2020-10-29 | 2023-04-04 | Cilag Gmbh International | Surgical instrument comprising a sensor configured to sense whether an articulation drive of the surgical instrument is actuatable |
US12053175B2 (en) | 2020-10-29 | 2024-08-06 | Cilag Gmbh International | Surgical instrument comprising a stowed closure actuator stop |
USD1013170S1 (en) | 2020-10-29 | 2024-01-30 | Cilag Gmbh International | Surgical instrument assembly |
US11717289B2 (en) | 2020-10-29 | 2023-08-08 | Cilag Gmbh International | Surgical instrument comprising an indicator which indicates that an articulation drive is actuatable |
US11931025B2 (en) | 2020-10-29 | 2024-03-19 | Cilag Gmbh International | Surgical instrument comprising a releasable closure drive lock |
US11534259B2 (en) | 2020-10-29 | 2022-12-27 | Cilag Gmbh International | Surgical instrument comprising an articulation indicator |
US11779330B2 (en) | 2020-10-29 | 2023-10-10 | Cilag Gmbh International | Surgical instrument comprising a jaw alignment system |
US11517390B2 (en) | 2020-10-29 | 2022-12-06 | Cilag Gmbh International | Surgical instrument comprising a limited travel switch |
US11452526B2 (en) | 2020-10-29 | 2022-09-27 | Cilag Gmbh International | Surgical instrument comprising a staged voltage regulation start-up system |
US11744581B2 (en) | 2020-12-02 | 2023-09-05 | Cilag Gmbh International | Powered surgical instruments with multi-phase tissue treatment |
US11737751B2 (en) | 2020-12-02 | 2023-08-29 | Cilag Gmbh International | Devices and methods of managing energy dissipated within sterile barriers of surgical instrument housings |
US11653915B2 (en) | 2020-12-02 | 2023-05-23 | Cilag Gmbh International | Surgical instruments with sled location detection and adjustment features |
US11890010B2 (en) | 2020-12-02 | 2024-02-06 | Cllag GmbH International | Dual-sided reinforced reload for surgical instruments |
US11849943B2 (en) | 2020-12-02 | 2023-12-26 | Cilag Gmbh International | Surgical instrument with cartridge release mechanisms |
US11678882B2 (en) | 2020-12-02 | 2023-06-20 | Cilag Gmbh International | Surgical instruments with interactive features to remedy incidental sled movements |
US11653920B2 (en) | 2020-12-02 | 2023-05-23 | Cilag Gmbh International | Powered surgical instruments with communication interfaces through sterile barrier |
US11944296B2 (en) | 2020-12-02 | 2024-04-02 | Cilag Gmbh International | Powered surgical instruments with external connectors |
US11627960B2 (en) | 2020-12-02 | 2023-04-18 | Cilag Gmbh International | Powered surgical instruments with smart reload with separately attachable exteriorly mounted wiring connections |
US11812964B2 (en) | 2021-02-26 | 2023-11-14 | Cilag Gmbh International | Staple cartridge comprising a power management circuit |
US11696757B2 (en) | 2021-02-26 | 2023-07-11 | Cilag Gmbh International | Monitoring of internal systems to detect and track cartridge motion status |
US11950779B2 (en) | 2021-02-26 | 2024-04-09 | Cilag Gmbh International | Method of powering and communicating with a staple cartridge |
US11723657B2 (en) | 2021-02-26 | 2023-08-15 | Cilag Gmbh International | Adjustable communication based on available bandwidth and power capacity |
US11730473B2 (en) | 2021-02-26 | 2023-08-22 | Cilag Gmbh International | Monitoring of manufacturing life-cycle |
US11751869B2 (en) | 2021-02-26 | 2023-09-12 | Cilag Gmbh International | Monitoring of multiple sensors over time to detect moving characteristics of tissue |
US11744583B2 (en) | 2021-02-26 | 2023-09-05 | Cilag Gmbh International | Distal communication array to tune frequency of RF systems |
US11950777B2 (en) | 2021-02-26 | 2024-04-09 | Cilag Gmbh International | Staple cartridge comprising an information access control system |
US11793514B2 (en) | 2021-02-26 | 2023-10-24 | Cilag Gmbh International | Staple cartridge comprising sensor array which may be embedded in cartridge body |
US11925349B2 (en) | 2021-02-26 | 2024-03-12 | Cilag Gmbh International | Adjustment to transfer parameters to improve available power |
US11701113B2 (en) | 2021-02-26 | 2023-07-18 | Cilag Gmbh International | Stapling instrument comprising a separate power antenna and a data transfer antenna |
US11980362B2 (en) | 2021-02-26 | 2024-05-14 | Cilag Gmbh International | Surgical instrument system comprising a power transfer coil |
US11749877B2 (en) | 2021-02-26 | 2023-09-05 | Cilag Gmbh International | Stapling instrument comprising a signal antenna |
US11737749B2 (en) | 2021-03-22 | 2023-08-29 | Cilag Gmbh International | Surgical stapling instrument comprising a retraction system |
US11826012B2 (en) | 2021-03-22 | 2023-11-28 | Cilag Gmbh International | Stapling instrument comprising a pulsed motor-driven firing rack |
US11826042B2 (en) | 2021-03-22 | 2023-11-28 | Cilag Gmbh International | Surgical instrument comprising a firing drive including a selectable leverage mechanism |
US11717291B2 (en) | 2021-03-22 | 2023-08-08 | Cilag Gmbh International | Staple cartridge comprising staples configured to apply different tissue compression |
US11723658B2 (en) | 2021-03-22 | 2023-08-15 | Cilag Gmbh International | Staple cartridge comprising a firing lockout |
US11806011B2 (en) | 2021-03-22 | 2023-11-07 | Cilag Gmbh International | Stapling instrument comprising tissue compression systems |
US11759202B2 (en) | 2021-03-22 | 2023-09-19 | Cilag Gmbh International | Staple cartridge comprising an implantable layer |
US11786239B2 (en) | 2021-03-24 | 2023-10-17 | Cilag Gmbh International | Surgical instrument articulation joint arrangements comprising multiple moving linkage features |
US11896218B2 (en) | 2021-03-24 | 2024-02-13 | Cilag Gmbh International | Method of using a powered stapling device |
US11849944B2 (en) | 2021-03-24 | 2023-12-26 | Cilag Gmbh International | Drivers for fastener cartridge assemblies having rotary drive screws |
US11896219B2 (en) | 2021-03-24 | 2024-02-13 | Cilag Gmbh International | Mating features between drivers and underside of a cartridge deck |
US11832816B2 (en) | 2021-03-24 | 2023-12-05 | Cilag Gmbh International | Surgical stapling assembly comprising nonplanar staples and planar staples |
US11793516B2 (en) | 2021-03-24 | 2023-10-24 | Cilag Gmbh International | Surgical staple cartridge comprising longitudinal support beam |
US11786243B2 (en) | 2021-03-24 | 2023-10-17 | Cilag Gmbh International | Firing members having flexible portions for adapting to a load during a surgical firing stroke |
US11903582B2 (en) | 2021-03-24 | 2024-02-20 | Cilag Gmbh International | Leveraging surfaces for cartridge installation |
US11744603B2 (en) | 2021-03-24 | 2023-09-05 | Cilag Gmbh International | Multi-axis pivot joints for surgical instruments and methods for manufacturing same |
US11849945B2 (en) | 2021-03-24 | 2023-12-26 | Cilag Gmbh International | Rotary-driven surgical stapling assembly comprising eccentrically driven firing member |
US11944336B2 (en) | 2021-03-24 | 2024-04-02 | Cilag Gmbh International | Joint arrangements for multi-planar alignment and support of operational drive shafts in articulatable surgical instruments |
US20220378425A1 (en) | 2021-05-28 | 2022-12-01 | Cilag Gmbh International | Stapling instrument comprising a control system that controls a firing stroke length |
US11980363B2 (en) | 2021-10-18 | 2024-05-14 | Cilag Gmbh International | Row-to-row staple array variations |
US11877745B2 (en) | 2021-10-18 | 2024-01-23 | Cilag Gmbh International | Surgical stapling assembly having longitudinally-repeating staple leg clusters |
US11957337B2 (en) | 2021-10-18 | 2024-04-16 | Cilag Gmbh International | Surgical stapling assembly with offset ramped drive surfaces |
US11937816B2 (en) | 2021-10-28 | 2024-03-26 | Cilag Gmbh International | Electrical lead arrangements for surgical instruments |
Family Cites Families (8)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US3885569A (en) | 1972-11-21 | 1975-05-27 | Birtcher Corp | Electrosurgical unit |
US4739759A (en) * | 1985-02-26 | 1988-04-26 | Concept, Inc. | Microprocessor controlled electrosurgical generator |
US6293942B1 (en) | 1995-06-23 | 2001-09-25 | Gyrus Medical Limited | Electrosurgical generator method |
US6843789B2 (en) * | 2000-10-31 | 2005-01-18 | Gyrus Medical Limited | Electrosurgical system |
EP1287788B1 (en) | 2001-08-27 | 2011-04-20 | Gyrus Medical Limited | Electrosurgical system |
US6929641B2 (en) * | 2001-08-27 | 2005-08-16 | Gyrus Medical Limited | Electrosurgical system |
US6966907B2 (en) * | 2001-08-27 | 2005-11-22 | Gyrus Medical Limited | Electrosurgical generator and system |
US6875210B2 (en) * | 2002-11-19 | 2005-04-05 | Conmed Corporation | Electrosurgical generator and method for cross-checking mode functionality |
-
2004
- 2004-11-12 GB GB0425051A patent/GB0425051D0/en not_active Ceased
-
2005
- 2005-09-27 WO PCT/GB2005/003721 patent/WO2006051252A1/en active Application Filing
- 2005-09-27 CN CNB2005800384053A patent/CN100531678C/en active Active
- 2005-09-27 AT AT05786860T patent/ATE442093T1/en not_active IP Right Cessation
- 2005-09-27 AU AU2005303650A patent/AU2005303650B2/en active Active
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- 2005-09-27 DE DE602005016592T patent/DE602005016592D1/en active Active
- 2005-09-27 EP EP05786860A patent/EP1814481B1/en active Active
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CN101072543A (en) | 2007-11-14 |
DE602005016592D1 (en) | 2009-10-22 |
ATE442093T1 (en) | 2009-09-15 |
AU2005303650A1 (en) | 2006-05-18 |
EP1814481A1 (en) | 2007-08-08 |
GB0425051D0 (en) | 2004-12-15 |
AU2005303650B2 (en) | 2011-05-12 |
EP1814481B1 (en) | 2009-09-09 |
CN100531678C (en) | 2009-08-26 |
WO2006051252A1 (en) | 2006-05-18 |
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